Department of Neurosurgery, School of Medicine, Uludag University, Gorukle Kampus, Bursa 16059, Turkey.
J Orthop Surg Res. 2008 Aug 28;3:37. doi: 10.1186/1749-799X-3-37.
Surgical treatment of metastatic spinal cord compression with or without neural deficit is controversial. Karnofsky and Tokuhashi scores have been proposed for prognosis of spinal metastasis. Here, we conducted a retrospective analysis of Karnofsky and modified Tokuhashi scores in 57 consecutive patients undergoing surgery for secondary spinal metastases to evaluate the value of these scores in aiding decision making for surgery. Comparison of preoperative Karnofsky and modified Tokuhashi scores with the type of the surgical approach for each patient revealed that both scores not only reliably estimate life expectancy, but also objectively improved surgical decisions. When the general status of the patient is poor (i.e., Karnofsky score less than 40% or modified Tokuhashi score of 5 or greater), palliative treatments and radiotherapy, rather than surgery, should be considered.
手术治疗伴或不伴神经功能缺损的转移性脊髓压迫存在争议。Karnofsky 和 Tokuhashi 评分被提出用于预测脊柱转移瘤的预后。在此，我们对 57 例接受手术治疗的继发性脊柱转移患者的 Karnofsky 和改良 Tokuhashi 评分进行回顾性分析，以评估这些评分在辅助手术决策中的价值。比较每位患者术前 Karnofsky 和改良 Tokuhashi 评分与手术方式的类型，结果显示，这两个评分不仅可靠地估计预期寿命，而且客观地改善了手术决策。当患者的一般状况较差（即 Karnofsky 评分低于 40%或改良 Tokuhashi 评分为 5 或更高）时，应考虑姑息治疗和放疗，而不是手术。
