Schimmelpenning Victoria H, Brugger Robin, Rommers Nikki, Kunst Johann, Jäger Martin, Albers Christoph E, Milavec Helena
Spine Unit, Department of Orthopaedic Surgery and Traumatology, Aarau Cantonal Hospital, 5001 Aarau, Switzerland.
Department of Clinical Research, University of Basel, University Hospital Basel, 4031 Basel, Switzerland.
Curr Oncol. 2025 Jan 13;32(1):38. doi: 10.3390/curroncol32010038.
The objective of this study was to analyze treatment approaches and outcomes according to patients' perspectives for patients with indeterminate spinal instability caused by neoplastic lesions. Data were collected from 31 patients with a total of 147 spinal neoplastic lesions, 29 of whom had lesions classified as indeterminate. These lesions were divided into two groups: the low indeterminate group (SINS 7-9) and the high indeterminate group (SINS 10-12). Conservative treatment was the primary approach (93%), resulting in improvement in 59% of cases, stability in 22%, and asymptomatic outcomes in 19%. No significant differences in self-reported outcomes were found between surgical and non-surgical treatments ( = 0.98, = 0.18). Surgery was reserved for patients with severe pain or impending neurological compromise. Our findings suggest that conservative management is a viable option for most patients with indeterminate spinal instability caused by neoplastic lesions, provided pain and neurological stability are adequately controlled.
本研究的目的是根据患者的观点，分析因肿瘤性病变导致的脊柱不稳定情况不明的患者的治疗方法和结果。收集了31例患者共147处脊柱肿瘤性病变的数据，其中29处病变被归类为情况不明。这些病变分为两组：低度情况不明组（脊柱不稳定评分7 - 9分）和高度情况不明组（脊柱不稳定评分10 - 12分）。保守治疗是主要方法（93%），59%的病例病情改善，22%病情稳定，19%无症状。手术治疗和非手术治疗在自我报告的结果方面未发现显著差异（P = 0.98，I² = 0.18）。手术仅适用于有严重疼痛或即将出现神经功能损害的患者。我们的研究结果表明，对于大多数因肿瘤性病变导致脊柱不稳定情况不明的患者，保守治疗是一种可行的选择，前提是疼痛和神经功能稳定性得到充分控制。
