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Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability.

Publication ,  Journal Article
Dial, BL; Catanzano, AA; Esposito, V; Steele, J; Fletcher, A; Ryan, SP; Kirkpatrick, JP; Goodwin, CR; Torok, J; Hopkins, T; Mendoza-Lattes, S
Published in: Global Spine J
April 2022

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The purpose of this study was to compare outcomes between different treatment modalities for metastatic disease with indeterminate instability (Spinal Instability Neoplastic Score [SINS] 7-12). METHODS: We retrospectively reviewed neurologically intact patients treated for spinal metastatic disease with a SINS of 7 to 12. The cohort was stratified by treatment approach: external beam radiation therapy alone (EBRT), surgery + EBRT (S+E), and cement augmentation + EBRT (K+E). Kaplan-Meier analysis was used to assess differences in length of survival (LOS) and ability to ambulate at time of death. Multivariate analysis was performed to assess adjusted LOS and ability to ambulate at time of death. RESULTS: The cohort included 211 patients, S+E (n = 57), EBRT (n = 128), and K+E (n = 27). In the S+E group, the median LOS was 430 days, which was statistically longer than the median LOS for the EBRT group (121 days) and the K+E group (169 days). In the S+E group, 52 patients (91.2%) and in the K+E group 24 patients (92.3%) retained the ability to ambulate at their time of death compared to 99 patients (77.3%) of the EBRT patients (P = .01). The overall rate of revision treatment at the spinal level initially treated was 17.5%, S+E (15.8%), EBRT (20.3%), and K+E (7.7%). CONCLUSIONS: The length of survival, ability to maintain ambulatory ability, and revision treatment rates were all improved following surgical management and radiation therapy compared to radiation therapy alone. The authors' conclusion from these results are that patients with indeterminate spinal instability should be discussed in a multidisciplinary setting for the need of spinal stabilization in addition to radiation therapy.

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Published In

Global Spine J

DOI

ISSN

2192-5682

Publication Date

April 2022

Volume

12

Issue

3

Start / End Page

373 / 380

Location

England

Related Subject Headings

  • 3202 Clinical sciences
 

Citation

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MLA
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Dial, B. L., Catanzano, A. A., Esposito, V., Steele, J., Fletcher, A., Ryan, S. P., … Mendoza-Lattes, S. (2022). Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability. Global Spine J, 12(3), 373–380. https://doi.org/10.1177/2192568220956605
Dial, Brian L., Anthony A. Catanzano, Valentine Esposito, John Steele, Amanda Fletcher, Sean P. Ryan, John P. Kirkpatrick, et al. “Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability.Global Spine J 12, no. 3 (April 2022): 373–80. https://doi.org/10.1177/2192568220956605.
Dial BL, Catanzano AA, Esposito V, Steele J, Fletcher A, Ryan SP, et al. Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability. Global Spine J. 2022 Apr;12(3):373–80.
Dial, Brian L., et al. “Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability.Global Spine J, vol. 12, no. 3, Apr. 2022, pp. 373–80. Pubmed, doi:10.1177/2192568220956605.
Dial BL, Catanzano AA, Esposito V, Steele J, Fletcher A, Ryan SP, Kirkpatrick JP, Goodwin CR, Torok J, Hopkins T, Mendoza-Lattes S. Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability. Global Spine J. 2022 Apr;12(3):373–380.
Journal cover image

Published In

Global Spine J

DOI

ISSN

2192-5682

Publication Date

April 2022

Volume

12

Issue

3

Start / End Page

373 / 380

Location

England

Related Subject Headings

  • 3202 Clinical sciences