Algoritm for surgical method of treatment at spine tumors

Authors

  • Volodymyr Radchenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-5949-0882
  • Andriy Popov Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-9006-7721
  • Dmytro Petrenko The Scientific-Practical Medical Centre of Kharkiv National Medical Univercity. Ukraine, Ukraine
  • Marina Nessonova Кharkiv National Medical University. Ukraine, Ukraine

DOI:

https://doi.org/10.15674/0030-59872020425-32

Keywords:

Spinal tumor, surgical treatment, instability scale SINS, decision tree, cluster analysis

Abstract

The main goal of  the primary and metastatic spinal tumors treatment are local control, preservation of weight bearing and protective function of the spine with improvement patients quality of life. Objective. To develop mathematical algorithm for selection of surgical treatment volume in spinal tumor cases. Methods. Spinal instability neoplastic score supplemented with additional signs such as ASIA scale, tumor type, epidural spinal cord compression scale by Bilsky, local kyphosis, adjacent vertebras lesions  was used for the model developing. Point system that takes 9 signs has been tested in 237 metastatic spinal tumor patients. Cluster analysis for the decision tree development was applied. Results. It has been confirmed the hypothesis about decreasing surgical volume with higher SINS score. But, it was not defined which boundary indicator to define specific volume of the surgery is precise. Two patients clusters were defined, that have differences in the surgical volume, degree of tumor lesion, epidural compression and local kyphosis, neurological symptoms. Cluster I included 115 patients with higher score (severe condition, higher volume of the surgical intervention) in comparison with 122 patients from the cluster II. Decision tree for the surgical volume selection in spinal tumor patients has been developed.  Conclusions. The most important signes that affect the choice of the surgical volume selection are: neurological symptoms, type of vertebra lesion, spinal stenosis and type of the surgery (radical vs palliative). Application of the deve­loped decision tree in the clinical practise gives the opportunity to select appropriate volume of the surgical intervention in spinal tumor patient with the high significance level that provides satisfactory treatment outcome.

Author Biographies

Volodymyr Radchenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Traumatology and Orthopаedics

Andriy Popov, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

 PhD in Traumatology and Orthopаedics

References

  1. Tokuhashi, Y., Matsuzaki, H., Oda, H., Oshima, M., & Ryu, J. (2005). A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine, 30(19), 2186-2191. https://doi.org/10.1097/01.brs.0000180401.06919.a5
  2. Findlay, G. F. (1984). Adverse effects of the management of malignant spinal cord compression. Journal of Neurology, Neurosurgery & Psychiatry, 47(8), 761-768. https://doi.org/10.1136/jnnp.47.8.761
  3. Steinmetz, M. P., Mekhail, A., & Benzel, E. C. (2001). Management of metastatic tumors of the spine: Strategies and operative indications. Neurosurgical Focus, 11(6), 1-6. https://doi.org/10.3171/foc.2001.11.6.3
  4. Ibrahim, A., Crockard, A., Antonietti, P., Boriani, S., Bünger, C., Gasbarrini, A., … & Tomita, K. (2008). Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Journal of Neurosurgery: Spine, 8(3), 271-278. https://doi.org/10.3171/spi/2008/8/3/271
  5. Patchell, R. A., Tibbs, P. A., Regine, W. F., Payne, R., Saris, S., Kryscio, R. J., Mohiuddin, M., & Young, B. (2005). Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: A randomised trial. The Lancet, 366(9486), 643-648. https://doi.org/10.1016/s0140-6736(05)66954-1
  6. Drakhshandeh, D., Miller, J. A., & Fabiano, A. J. (2018). Instrumented spinal stabilization without fusion for spinal metastatic disease. World Neurosurgery, 111, e403-e409. https://doi.org/10.1016/j.wneu.2017.12.081
  7. North, R. B., LaRocca, V. R., Schwartz, J., North, C. A., Zahurak, M., Davis, R. F., & McAfee, P. C. (2005). Surgical management of spinal metastases: Analysis of prognostic factors during a 10-year experience. Journal of Neurosurgery: Spine, 2(5), 564-573. https://doi.org/10.3171/spi.2005.2.5.0564
  8. Ciftdemir, M., Kaya, M., Selcuk, E., & Yalniz, E. (2016). Tumors of the spine. World Journal of Orthopedics, 7(2), 109. https://doi.org/10.5312/wjo.v7.i2.109
  9. Sakaura, H., Hosono, N., Mukai, Y., Ishii, T., Yonenobu, K., & Yoshikawa, H. (2004). Outcome of total en Bloc Spondylectomy for solitary metastasis of the thoracolumbar spine. Journal of Spinal Disorders & Techniques, 17(4), 297-300. https://doi.org/10.1097/01.bsd.0000096269.75373.9b
  10. Mazel, C., Balabaud, L., Bennis, S., & Hansen, S. (2009). Cervical and thoracic spine tumor management: Surgical indications, techniques, and outcomes. Orthopedic Clinics of North America, 40(1), 75-92. https://doi.org/10.1016/j.ocl.2008.09.008
  11. Sugita, S., Murakami, H., Yonezawa, N., Demura, S., Tanaka, S., & Tsuchiya, H. (2017). Radical surgery consisting of en Bloc corpectomy in recurrence after palliative surgery for spinal metastasis. Spine Surgery and Related Research, 1(2), 96-99. https://doi.org/10.22603/ssrr.1.2016-0020
  12. Fisher, C. G., DiPaola, C. P., Ryken, T. C., Bilsky, M. H., Shaffrey, C. I., Berven, S. H., … & Fourney, D. R. (2010). A novel classification system for spinal instability in neoplastic disease. Spine, 35(22), E1221-E1229. https://doi.org/10.1097/brs.0b013e3181e16ae2
  13. Bilsky, M. H., Laufer, I., Fourney, D. R., Groff, M., Schmidt, M. H., Varga, P. P., … & Kuklo, T. R. (2010). Reliability analysis of the epidural spinal cord compression scale. Journal of Neurosurgery: Spine, 13(3), 324-328. https://doi.org/10.3171/2010.3.spine09459
  14. Korzh, N. A., Kutsenko, V. A., Perfilyev, A. V., & Popov, A. I. (2020). Review of rating scales and classifications of metastatic lesions of the spine used in surgical treatment. Ukrainian Journal of Medicine, Biology and Sport, 5(27), 35-44. https://doi.org/10.26693/jmbs05.05.035. [in Russian]
  15. Tomita, K., Kawahara, N., Kobayashi, T., Yoshida, A., Murakami, H., & Akamaru, T. (2001). Surgical strategy for spinal metastases. Spine, 26(3), 298-306. https://doi.org/10.1097/00007632-200102010-00016
  16. Tokuhashi, Y., Matsuzaki, H., Oda, H., Oshima, M., & Ryu, J. (2005). A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine, 30(19), 2186-2191. https://doi.org/10.1097/01.brs.0000180401.06919.a5
  17. Uei, H., Tokuhashi, Y., & Maseda, M. (2017). Treatment outcome of metastatic spine tumor in lung cancer patients. Spine, 42(24), E1446-E1451. https://doi.org/10.1097/brs.0000000000002382
  18. Lam, Y. (2020). Bone tumors: benign bone tumors. FP Essentials, 493, 11-21
  19. Tokuhashi, Y., Uei, H., & Oshima, M. (2017). Classification and scoring systems for metastatic spine tumors: A literature review. Spine Surgery and Related Research, 1(2), 44-55. https://doi.org/10.22603/ssrr.1.2016-0021
  20. Roberts, T. T., Leonard, G. R., & Cepela, D. J. (2016). Classifications in brief: American spinal injury association (ASIA) impairment scale. Clinical Orthopaedics and Related Research, 475(5), 1499-1504. https://doi.org/10.1007/s11999-016-5133-4
  21. Khalafyan, A. A. (2008). Modern statistical methods of medical research. M.: LKI
  22. Gruzdev, A. V. (2016). Predictive Modeling in IBM SPSS Statistics and R. Decision Trees Method. Мoskow: DМК.
  23. Data Science Textbook. TIBCO Software Inc. Retrieved from: https://docs.tibco.com/data-science/textbook.
  24. Nessonova, M. N. (2018). Mathematical models and methods of constructing classifiers in medicin. LAMBERT Academic Publishing

Downloads

How to Cite

Radchenko, V., Popov, A., Petrenko, D., & Nessonova, M. (2023). Algoritm for surgical method of treatment at spine tumors. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 25–32. https://doi.org/10.15674/0030-59872020425-32

Issue

No. 4 (2020)

Section

ORIGINAL ARTICLES

License

Copyright (c) 2021 Volodymyr Radchenko, Andriy Popov, Dmytro Petrenko, Marina Nessonova

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).