Eline H Huele, Roxanne Gal, Wietse S C Eppinga, Helena M Verkooijen, John E O'Toole, Ilya Laufer, Daniel M Sciubba, Cordula Netzer, Wouter Foppen, Arjun Sahgal, Michael G Fehlings, Sheng-Fu L Lo, Charles G Fisher, Laurence D Rhines, Jeremy J Reynolds, Aron Lazary, Alessandro Gasbarrini, Nicolas Dea, Michael H Weber, Jorrit Jan Verlaan
{"title":"Risk Factors for the Development of Neurological Deficits in Metastatic Spinal Disease: An International, Multicenter Delphi Study.","authors":"Eline H Huele, Roxanne Gal, Wietse S C Eppinga, Helena M Verkooijen, John E O'Toole, Ilya Laufer, Daniel M Sciubba, Cordula Netzer, Wouter Foppen, Arjun Sahgal, Michael G Fehlings, Sheng-Fu L Lo, Charles G Fisher, Laurence D Rhines, Jeremy J Reynolds, Aron Lazary, Alessandro Gasbarrini, Nicolas Dea, Michael H Weber, Jorrit Jan Verlaan","doi":"10.1177/21925682231222424","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Delphi study.</p><p><strong>Objective: </strong>The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease.</p><p><strong>Methods: </strong>A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons. In round 1, participants listed radiological factors, patient characteristics, tumor characteristics, previous cancer-related treatment factors and additional factors. In round 2, participants ranked the factors on importance per category and selected a top 9 from all factors. Kendall's W coefficient of concordance was calculated as a measure of consensus. In the final round, participants provided feedback on the rankings resulting from round 2. Lastly, the highest-ranking factors were more clearly defined and operationalized by an expert panel.</p><p><strong>Results: </strong>Over two hundred physicians and researchers participated in each round. The factors listed in the first round were collapsed into 12 radiological factors, 14 patient characteristics, 6 tumor characteristics and 12 previous cancer-related treatment factors. High agreement was found in round 3 on the top-half lists in each category and the overall top 9, originating from round 2. Kendall's W indicated strong agreement between the participants. 'Epidural spinal cord compression', 'aggressive tumor behavior' and 'mechanical instability' were deemed most influential for the development of neurological deficits.</p><p><strong>Conclusion: </strong>This study provides factors that may be related to the development and/or progression of neurological deficits in patients with metastatic spinal disease. This list can serve as a basis for future directions in prognostication research.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1_suppl","pages":"93S-103S"},"PeriodicalIF":2.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726512/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/21925682231222424","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Study design: Delphi study.
Objective: The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease.
Methods: A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons. In round 1, participants listed radiological factors, patient characteristics, tumor characteristics, previous cancer-related treatment factors and additional factors. In round 2, participants ranked the factors on importance per category and selected a top 9 from all factors. Kendall's W coefficient of concordance was calculated as a measure of consensus. In the final round, participants provided feedback on the rankings resulting from round 2. Lastly, the highest-ranking factors were more clearly defined and operationalized by an expert panel.
Results: Over two hundred physicians and researchers participated in each round. The factors listed in the first round were collapsed into 12 radiological factors, 14 patient characteristics, 6 tumor characteristics and 12 previous cancer-related treatment factors. High agreement was found in round 3 on the top-half lists in each category and the overall top 9, originating from round 2. Kendall's W indicated strong agreement between the participants. 'Epidural spinal cord compression', 'aggressive tumor behavior' and 'mechanical instability' were deemed most influential for the development of neurological deficits.
Conclusion: This study provides factors that may be related to the development and/or progression of neurological deficits in patients with metastatic spinal disease. This list can serve as a basis for future directions in prognostication research.
期刊介绍：
Global Spine Journal (GSJ) is the official scientific publication of AOSpine. A peer-reviewed, open access journal, devoted to the study and treatment of spinal disorders, including diagnosis, operative and non-operative treatment options, surgical techniques, and emerging research and clinical developments.GSJ is indexed in PubMedCentral, SCOPUS, and Emerging Sources Citation Index (ESCI).
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