{"title":"Global trends in the utilisation of NOMS framework for spinal metastasis management: A systematic review.","authors":"J F L Tobing, E Kow, S D A L Tobing","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Traditional risk stratification systems based on the clinicopathological criteria have limitations and may not accurately predict outcomes for all patients. The neurologic, oncologic, mechanical, and systemic (NOMS) framework aims to optimise treatment outcomes and improve patient care. Here, we aimed to provide a comprehensive overview of the NOMS framework within the context of spinal metastasis.</p><p><strong>Materials and methods: </strong>The study rigorously followed the guidelines set by PRISMA. We conducted an extensive search and be as transparent as possible across wellregarded databases such as PubMed and Euro PMC. The primary outcome measure focused on examining the feasibility of implementing the NOMS framework for patients with spinal metastasis in real-world clinical settings, and this measure was predefined and justified.</p><p><strong>Results: </strong>This systematic review included three studies involving 300 participants with spinal metastases at the cervicothoracic junction. The studies examined surgical interventions like decompression, fusion and corpectomy within the NOMS framework. Across the studies, the NOMS approach is consistently associated with adverse outcomes, including complication rates, surgical revisions, hardware complications, deformities, tumour recurrence and variable survival rates. It is also linked to hospital stays, ICU durations and specific discharge statuses. Another study focused on spinal metastasis patients undergoing endoscopic surgery, highlighting the NOMS framework's connection to recurrence rates, performance metrics, neurological status, pain management, functional recovery and quality of life. In addition, other studies explored navigated instrumentation, with a primary focus on screw placement accuracy. All three studies demonstrated methodological rigor by reporting adequate allocation concealment.</p><p><strong>Conclusion: </strong>NOMS framework consistently associates with adverse spinal metastasis surgery outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 5","pages":"608-614"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Malaysia","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Traditional risk stratification systems based on the clinicopathological criteria have limitations and may not accurately predict outcomes for all patients. The neurologic, oncologic, mechanical, and systemic (NOMS) framework aims to optimise treatment outcomes and improve patient care. Here, we aimed to provide a comprehensive overview of the NOMS framework within the context of spinal metastasis.
Materials and methods: The study rigorously followed the guidelines set by PRISMA. We conducted an extensive search and be as transparent as possible across wellregarded databases such as PubMed and Euro PMC. The primary outcome measure focused on examining the feasibility of implementing the NOMS framework for patients with spinal metastasis in real-world clinical settings, and this measure was predefined and justified.
Results: This systematic review included three studies involving 300 participants with spinal metastases at the cervicothoracic junction. The studies examined surgical interventions like decompression, fusion and corpectomy within the NOMS framework. Across the studies, the NOMS approach is consistently associated with adverse outcomes, including complication rates, surgical revisions, hardware complications, deformities, tumour recurrence and variable survival rates. It is also linked to hospital stays, ICU durations and specific discharge statuses. Another study focused on spinal metastasis patients undergoing endoscopic surgery, highlighting the NOMS framework's connection to recurrence rates, performance metrics, neurological status, pain management, functional recovery and quality of life. In addition, other studies explored navigated instrumentation, with a primary focus on screw placement accuracy. All three studies demonstrated methodological rigor by reporting adequate allocation concealment.
Conclusion: NOMS framework consistently associates with adverse spinal metastasis surgery outcomes.
期刊介绍：
Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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