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SAGE
Global Spine Journal
,  том 15 ,  издание 1_suppl ,  страницы 132S-142S

What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?

William Chu Kwan 1
, 
Scott L. Zuckerman 2
, 
Charles G. Fisher 1
, 
Ilya Laufer 3
, 
Dean Chou 4
, 
John E. O’Toole 5
, 
Markus Schultheiss 6
, 
Michael H. Weber 7
, 
Daniel M. Sciubba 8
, 
Markian Pahuta 9
, 
John H. Shin 10
, 
Michael G. Fehlings 11
, 
Anne L. Versteeg 12
, 
Matthew L. Goodwin 13
, 
Stefano Boriani 14
, 
Chetan Bettegowda 15
, 
Áron Lazáry 16
, 
Alessandro Gasbarrini 14
, 
Jeremy J. Reynolds 17
, 
Jorrit-Jan Verlaan 18
, 
Arjun Sahgal 19
, 
Ziya L. Gokaslan 20
, 
Laurence D. Rhines 21
, 
Nicolas Dea 1
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, New York, NY, USA | 
9
 
10
 
11
 
12
 
13
 
14
 
15
 
16
 
National Center For Spinal Disorders, Budapest, Hungary | 
17
 
18
 
19
 
20
 
21
 
Тип публикации: Journal Article
Дата публикации: 2025-01-13
SAGE
scimago Q1
wos Q1
БС1
SJR: 1.153
CiteScore: 6.8
Impact factor: 3.0
ISSN: 21925682, 21925690
Краткое описание
Study Design

Systematic review.

Objective

In patients with extradural metastatic spine disease, we sought to systematically review the outcomes and complications of patients with intermediate Spinal Instability Neoplastic Score (SINS) lesions undergoing radiation therapy, percutaneous interventions, minimally invasive surgeries, or open spinal surgeries.

Methods

Following PRISMA guidelines for systematic reviews, MEDLINE, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews and the Cochrane Center Register of Controlled Trials were queried for studies that reported on SINS intermediate patients who underwent: 1) radiotherapy, 2) percutaneous intervention, 3) minimally invasive, or 4) open surgery. Dates of publication were between 2013-22. Patients with low- or high-grade SINS were excluded. Outcome measures were pain score, functional status, neurological outcome, ambulation, survival, and perioperative complications.

Results

Thirty-nine studies (n = 4554) were included that analyzed outcomes in the SINS intermediate cohort. Radiotherapy appeared to provide temporary improvement in pain score; however, recurrent pain led to surgery in 15%–20% of patients. Percutaneous vertebral augmentation provided improvement in pain. Minimally invasive surgery and open surgery offered improvement in pain, quality of life, neurological, and ambulatory outcomes. Open surgery may be associated with more complications. There was limited evidence for radiofrequency ablation.

Conclusion

In the SINS intermediate group, radiotherapy was associated with temporary improvement of pain but may require subsequent surgery. Both minimally invasive surgery and open spinal surgery achieved improvements in pain, quality of life, and neurological outcomes for patients with spine metastases. Open surgery may be associated with more complications.

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Chu Kwan W. et al. What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate? // Global Spine Journal. 2025. Vol. 15. No. 1_suppl. p. 132S-142S.
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Chu Kwan W., Zuckerman S. L., Fisher C. G., Laufer I., Chou D., O’Toole J. E., Schultheiss M., Weber M. H., Sciubba D. M., Pahuta M., Shin J. H., Fehlings M. G., Versteeg A. L., Goodwin M. L., Boriani S., Bettegowda C., Lazáry Á., Gasbarrini A., Reynolds J. J., Verlaan J., Sahgal A., Gokaslan Z. L., Rhines L. D., Dea N. What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate? // Global Spine Journal. 2025. Vol. 15. No. 1_suppl. p. 132S-142S.
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TY - JOUR
DO - 10.1177/21925682231220551
UR - https://journals.sagepub.com/doi/10.1177/21925682231220551
TI - What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?
T2 - Global Spine Journal
AU - Chu Kwan, William
AU - Zuckerman, Scott L.
AU - Fisher, Charles G.
AU - Laufer, Ilya
AU - Chou, Dean
AU - O’Toole, John E.
AU - Schultheiss, Markus
AU - Weber, Michael H.
AU - Sciubba, Daniel M.
AU - Pahuta, Markian
AU - Shin, John H.
AU - Fehlings, Michael G.
AU - Versteeg, Anne L.
AU - Goodwin, Matthew L.
AU - Boriani, Stefano
AU - Bettegowda, Chetan
AU - Lazáry, Áron
AU - Gasbarrini, Alessandro
AU - Reynolds, Jeremy J.
AU - Verlaan, Jorrit-Jan
AU - Sahgal, Arjun
AU - Gokaslan, Ziya L.
AU - Rhines, Laurence D.
AU - Dea, Nicolas
PY - 2025
DA - 2025/01/13
PB - SAGE
SP - 132S-142S
IS - 1_suppl
VL - 15
SN - 2192-5682
SN - 2192-5690
ER -
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@article{2025_Chu Kwan,
author = {William Chu Kwan and Scott L. Zuckerman and Charles G. Fisher and Ilya Laufer and Dean Chou and John E. O’Toole and Markus Schultheiss and Michael H. Weber and Daniel M. Sciubba and Markian Pahuta and John H. Shin and Michael G. Fehlings and Anne L. Versteeg and Matthew L. Goodwin and Stefano Boriani and Chetan Bettegowda and Áron Lazáry and Alessandro Gasbarrini and Jeremy J. Reynolds and Jorrit-Jan Verlaan and Arjun Sahgal and Ziya L. Gokaslan and Laurence D. Rhines and Nicolas Dea},
title = {What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?},
journal = {Global Spine Journal},
year = {2025},
volume = {15},
publisher = {SAGE},
month = {jan},
url = {https://journals.sagepub.com/doi/10.1177/21925682231220551},
number = {1_suppl},
pages = {132S--142S},
doi = {10.1177/21925682231220551}
}
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Chu Kwan, William, et al. “What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?.” Global Spine Journal, vol. 15, no. 1_suppl, Jan. 2025, pp. 132S-142S. https://journals.sagepub.com/doi/10.1177/21925682231220551.