Abstract:
STUDY DESIGN:Retrospective clinical study. OBJECTIVE:The aim of this study was to examine whether the Tokuhashi score correlates with the neurologic outcome in early surgical treatment in metastatic spinal cord compression (MSCC). A retrospective analysis of 35 consecutive incomplete tetraplegic and paraplegic patients with vertebral metastases (VM) and spinal cord compression (SCC) was performed. SUMMARY OF BACKGROUND DATA:MSCC is a challenging problem in VM and constitutes an oncologic emergency. The Tokuhashi score has been modified recently and seems to constitute the best method of prediction for real survival in patients with VM. Until now the influence of the neurologic status as a prognostic factor has been discussed controversially. METHODS:Data of 35 patients with VM and incomplete tetraplegia or paraplegia, who underwent surgical treatment, were reviewed retrospectively from 2005 to 2006 at our hospital. All patients were classified among the American Spinal Injury Association (ASIA) Impairment Scale (AIS) before and after surgery and at the follow-up. Data were analyzed with SPSS 15.0 and correlation coefficients (Spearman rho) were computed. RESULTS:Analysis showed that 19 patients (54.3%) with an average Tokuhashi score of 9 showed an improvement in the AIS, whereas 12 (34.3%) patients with an average score of 8 had no change and 4 (11.4%) patients with a score of 7 had deterioration. AIS changes showed a positive correlation with Tokuhashi score (r = 0.33; P = 0.048). CONCLUSION:Our clinical observation suggests that patients with spinal metastases and a high Tokuhashi score benefit from surgical treatment with moderate improvement in sensomotoric function even in a heterogenic collective.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Putz C,Wiedenhöfer B,Gerner HJ,Fürstenberg CHdoi
10.1097/BRS.0b013e318188b98fsubject
Has Abstractpub_date
2008-11-15 00:00:00pages
2669-74issue
24eissn
0362-2436issn
1528-1159journal_volume
33pub_type
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