转移性脊柱肿瘤的临床评估、诊断和决策:WFNS 脊柱委员会建议。

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Sandeep Vaishya, Vibha Gaonkar, Manbachan Singh Bedi, Onur Yaman, Mehmet Zileli, Salman Sharif
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引用次数: 0

摘要

简介脊柱转移是晚期癌症患者的一个重大问题,会导致疼痛、神经功能障碍和生活质量下降。多达 70% 的癌症患者会出现脊柱转移,而椎体是最常见的骨转移部位1-3。大约 10% 的椎体转移患者最终会出现脊髓压迫,这可能会导致严重的永久性残疾4-6。本文旨在总结世界神经外科学会联合会(WFNS)脊柱委员会就转移性脊柱肿瘤的临床评估、诊断和决策所达成的共识声明:方法:使用 "临床评估 "+"脊柱转移"、"脊柱转移 "+"诊断 "和 "脊柱转移 "+"决策 "+"治疗 "等检索词,在 PubMed 和 Google Scholar 上对 2014 年至 2023 年的文献进行了系统检索。根据对这些文献的审查,WFNS 脊柱委员会的六名成员采用德尔菲法制定了五项共识声明,并在两次国际会议上进行了两轮投票:我们一致认为,对于癌症患者和 60 岁以上新发骨折/神经功能缺损的成年患者,需要高度怀疑才能早期发现和诊断脊柱转移。疼痛是最常见的症状,其次是运动障碍。近一半的转移性脊髓压迫患者会出现排便和膀胱功能障碍。治疗脊柱转移瘤的有效方法应该是缓解疼痛、控制肿瘤、预防神经功能受损和治疗不稳定性。分离手术联合 SRS 是治疗脊柱转移瘤的有效方法:这些共识声明为脊柱转移性肿瘤患者的临床评估、诊断和决策提供了循证指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical evaluation, diagnosis, and decision-making for metastatic spine tumors: WFNS spine committee recommendations.

Introduction: Spinal metastases are a significant concern for patients with advanced cancer, leading to pain, neurological deficits, and reduced quality of life. They occur in up to 70% of cancer patients, with the vertebral column being the most common osseous site for metastatic disease1-3. An approximate 10% of patients with vertebral body metastases eventually develop spinal cord compression, which can potentially cause severe and permanent disability4-6. This article aims to summarize the consensus statements developed by the World Federation of Neurosurgical Societies (WFNS) Spine Committee on the clinical evaluation, diagnosis, and decision-making for metastatic spine tumors.

Methods: A systematic literature search was conducted in PubMed and Google Scholar from 2014 to 2023 using the search terms "clinical evaluation" + "spine metastases," "spine metastases" + "diagnosis," and "spine metastases" + "decision making" + "treatment." Based on the review of this literature, six members of the WFNS Spine Committee developed five consensus statements using the Delphi method, which were voted on during two rounds of voting at two international meetings.

Results: We agree that a high index of suspicion is required for early detection and diagnosis of spinal metastasis in cancer patients and adult patients more than 60 years presenting with new onset fractures / neurological deficits. Pain is the most common symptom followed by motor deficit. Bowel and bladder dysfunction is noted in nearly half of patients with metastatic spinal cord compression. An effective treatment for spinal metastases should be able to achieve pain relief, tumor control, prevention of neurological compromise and treat instability. Separation surgery combined with SRS is an effective treatment for spinal metastases.

Conclusion: These consensus statements provide evidence-based guidelines for clinical evaluation, diagnosis, and decision-making in patients with metastatic spine tumors.

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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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