An analysis of tumor-related potential spinal column instability (Spine Instability Neoplastic Scores 7–12) eventually requiring surgery with a 1-year follow-up

OBJECTIVE Within the Spine Instability Neoplastic Score (SINS) classification, tumor-related potential spinal instability (SINS 7–12) may not have a clear treatment approach. The authors aimed to examine proportion of patients in this indeterminate zone who later required surgical stabilization after initial nonoperative management. By studying patient population, they sought determine if SINS cutoff existed whereby spine is potentially unstable due lesion and would be more likely require stabilization. METHODS Records from treated at University California, San Francisco, for metastatic disease 2005 2019 were retrospectively reviewed. Seventy-five with initially nonoperatively included. All had least 1-year follow-up complete medical records. A univariate chi-square test Student t-test used compare categorical continuous outcomes, respectively, between ultimately underwent surgery those did not. backward likelihood multivariate binary logistic regression model was investigate relationship clinical characteristics intervention. Recursive partitioning analysis (RPA) single-variable performed as function SINS. RESULTS total 292 sites included study; 26 (34.7%) intervention, 49 (65.3%) There no difference age, sex, comorbidities, or location groups. However, there 12 group (55.2%) than (44.8%) (p = 0.003). On analysis, > 11 (OR 8.09, CI 1.96–33.4, p 0.004) Karnofsky Performance Scale (KPS) score < 60 0.94, 0.89–0.98, 0.008) associated an increased risk surgery. KPS correlated 0.4). RPA by each identified optimal value 10, which Patients intervention higher incidence complications on multivariable 2.96, 1.01–8.71, 0.048). CONCLUSIONS mean greater mechanical requiring showed that lower 10 rates.