A Novel Classification System for Spinal Instability in Neoplastic Disease: An Evidence-Based Approach and Expert Consensus From the Spine Oncology Study Group

@article{Fisher2009ANC,
  title={A Novel Classification System for Spinal Instability in Neoplastic Disease: An Evidence-Based Approach and Expert Consensus From the Spine Oncology Study Group},
  author={Charles G. Fisher and Christian P. Dipaola and Timothy Ryken and Mark H Bilsky and Christopher I Shaffrey and Sigurd H. Berven and James S. Harrop and Michael G. Fehlings and Stefano Boriani and Dean Chou and Meic H. Schmidt and David W Polly and Roberto Biagini and Shane Burch and Mark B. Dekutoski and Aruna Ganju and Peter C. Gerszten and Ziya L. Gokaslan and Michael W Groff and Norbert J. Liebsch and Ehud Mendel and Scott H. Okuno and Shreyaskumar R Patel and Laurence D. Rhines and Peter S Rose and Daniel M. Sciubba and Narayan Sundaresan and Katsuro Tomita and Peter Pal Varga and Luiz Roberto Gomes Vialle and Frank D. Vrionis and Yoshiya Josh Yamada and Daryl R. Fourney},
  journal={Spine},
  year={2009},
  volume={35},
  pages={E1221-E1229}
}
Study Design. Systematic review and modified Delphi technique. Objective. To use an evidence-based medicine process using the best available literature and expert opinion consensus to develop a comprehensive classification system to diagnose neoplastic spinal instability. Summary of Background Data. Spinal instability is poorly defined in the literature and presently there is a lack of guidelines available to aid in defining the degree of spinal instability in the setting of neoplastic spinal… 

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...

References

SHOWING 1-10 OF 52 REFERENCES

Instability and impending instability of the thoracolumbar spine in patients with spinal metastases: a systematic review.

Metastatic disease commonly occurs in the spine and incidence is likely to increase secondary to improved survival rates in many cancer patients. Despite published research on instability in patients

Diagnosis and Management of a Metastatic Tumor in the Atlantoaxial Spine

The experience of a large multidisciplinary tertiary referral oncology center in diagnosing and managing metastatic disease of the atlantoaxial spine in the era of magnetic resonance imaging is reviewed to establish treatment parameters.

Metastatic Disease of the Spine

New data documenting the benefit of surgical decompression using improved techniques such as anterior approaches have amplified the role of the spine surgeon in the care of these patients.

An evaluation of spinal deformity in metastatic breast cancer.

Understanding the natural history of metastatic spinal deformity, instability and spinal canal compromise can be recognized and treated early, before the onset of progressive deformity and neurologic sequelae.

A Revised Scoring System for Preoperative Evaluation of Metastatic Spine Tumor Prognosis

The consistency rate between the predicted prognosis from the criteria of the total scores and the actual survival period was high in patients within each score range and a similar result was also observed in both the surgical procedure group and conservative treatmentgroup.

Surgical Strategy for Spinal Metastases

A new surgical strategy for spinal metastases based on the prognostic scoring system is proposed and provides appropriate guidelines for treatment in all patients with spinal metastased patients.

Metastatic disease in long bones: A proposed scoring system for diagnosing impending pathologic fractures. 1989.

  • H. Mirels
  • Medicine
    Clinical orthopaedics and related research
  • 2003
A weighted scoring system is proposed to quantify the risk of sustaining a pathologic fracture through a metastatic lesion in a long bone and it is suggested that all metastatic lesions in long bones be evaluated prior to irradiation.

Spinal Stabilization of Vertebral Column Tumors

An analysis of indications, techniques, results of stabilization and decompression of 100 consecutive spinal tumour cases was carried out and acrylic cement was used both anteriorly and posteriorly together with implant stabilization.

Methods of Surgical Stabilization for Metastatic Disease of the Spine

The present scope of such surgical procedures is reviewed along with identification of the most reliable selection factors for surgical candidates in order to improve functional outcome from surgical treatment of metastatic disease of the spine.
...