Recent Advances in Spine Tumor Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 1894

Special Issue Editor


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Guest Editor
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
Interests: spinal tumor; spinal metastasis; pathologic fracture; cord compression; separation surgery; radiotherapy; multidiscplinary approach

Special Issue Information

Dear Colleagues,

This Special Issue provides a comprehensive overview of the latest advancements in the field of spine tumor diagnosis and treatment. Highlighting critical developments in spinal tumor management, the issue explores innovative approaches to diagnosing and treating spinal metastases, pathologic fractures, and cord compression. It delves into the evolving role of the surgeon, the integration of radiotherapy, and the importance of interdisciplinary collaboration between surgeons, medical oncologists, and radiologic oncologists. Additionally, the issue addresses the psychological aspects and pain management strategies essential for improving patient outcomes. Through cutting-edge research and expert insights, this edition aims to enhance understanding and foster advancements in spine tumor care.

Dr. Jae Hwan Cho
Guest Editor

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Keywords

  • spine tumor
  • spinal metastasis
  • pathologic fracture
  • cord compression
  • separation surgery
  • radiotherapy
  • interdisciplinary collaboration
  • surgeon’s role
  • medical oncologist
  • radiologic oncologist
  • psychological aspects
  • pain management
  • innovative approaches
  • patient outcomes
  • diagnostic advancements

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Published Papers (2 papers)

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Research

12 pages, 768 KiB  
Article
Impact of the Spinal Instability Neoplastic Score on Postoperative Prognosis in Patients with Metastatic Cancer of the Cervical Spine
by Dong-Ho Kang, Kyunghun Jung, Jin-Sung Park, Minwook Kang, Chong-Suh Lee and Se-Jun Park
J. Clin. Med. 2024, 13(24), 7860; https://doi.org/10.3390/jcm13247860 - 23 Dec 2024
Viewed by 881
Abstract
Background: Although the Spinal Instability Neoplastic Score (SINS) is widely utilized to evaluate spinal instability, its prognostic value for survival in patients with cervical spinal metastases remains unclear. This study investigated the association between the SINS and survival outcomes in patients with metastatic [...] Read more.
Background: Although the Spinal Instability Neoplastic Score (SINS) is widely utilized to evaluate spinal instability, its prognostic value for survival in patients with cervical spinal metastases remains unclear. This study investigated the association between the SINS and survival outcomes in patients with metastatic cervical spine cancer. Methods: This retrospective cohort study included 106 patients who underwent surgery for metastatic cervical spine cancer at a single institution between 1995 and 2023. Patients were divided into two groups: high SINS (≥13) and low-to-moderate SINS (0–12). Overall survival (OS) was the primary outcome and was analyzed using Kaplan–Meier estimates and Cox regression. Secondary outcomes included changes in Eastern Cooperative Oncology Group Performance Status (ECOG-PS), operation time, estimated blood loss, and postoperative complications. Results: The median OS was significantly shorter in the high SINS group compared to the low-to-moderate SINS group (5.3 months versus 8.6 months; p = 0.023). A high SINS was independently associated with increased mortality risk (hazard ratio [HR], 1.959; 95% CI, 1.221–3.143; p = 0.005). Lung cancer (HR, 4.004; 95% CI, 1.878–8.535; p < 0.001) and rectal cancer (HR, 3.293; 95% CI, 1.126–9.632; p = 0.029) were predictive of worse survival, whereas postoperative chemotherapy (HR, 0.591; 95% CI, 0.381–0.917; p = 0.019) and radiotherapy (HR, 0.531; 95% CI, 0.340–0.827; p = 0.005) were associated with improved survival. Changes in the ECOG-PS and postoperative complication rates were not significantly different between the groups. Conclusions: A high SINS was associated with significantly shorter survival in patients with metastatic cervical spine cancer, reflecting both mechanical instability and tumor aggressiveness. Full article
(This article belongs to the Special Issue Recent Advances in Spine Tumor Diagnosis and Treatment)
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14 pages, 2079 KiB  
Article
Can Preoperative Hounsfield Unit Measurement Help Predict Mechanical Failure in Metastatic Spinal Tumor Surgery?
by Hyung Rae Lee, Jae Hwan Cho, Sang Yun Seok, San Kim, Dae Wi Cho and Jae Hyuk Yang
J. Clin. Med. 2024, 13(23), 7017; https://doi.org/10.3390/jcm13237017 - 21 Nov 2024
Viewed by 686
Abstract
Background/Objectives: This study aimed to identify risk factors associated with mechanical failure in patients undergoing spinal instrumentation without fusion for metastatic spinal tumors. Methods: We retrospectively evaluated data from 220 patients with spinal tumors who underwent instrumentation without fusion. Propensity scores were used [...] Read more.
Background/Objectives: This study aimed to identify risk factors associated with mechanical failure in patients undergoing spinal instrumentation without fusion for metastatic spinal tumors. Methods: We retrospectively evaluated data from 220 patients with spinal tumors who underwent instrumentation without fusion. Propensity scores were used to match preoperative variables, resulting in the inclusion of 24 patients in the failure group (F group) and 72 in the non-failure group (non-F group). Demographic, surgical, and radiological characteristics were compared between the two groups. Logistic regression and Kaplan–Meier survival analyses were conducted to identify predictors of mechanical failure. Results: Propensity score matching resulted in a balanced distribution of covariates. Lower Hounsfield unit (HU) values at the lowest instrumented vertebra (LIV) were the only independent predictor of implant failure (p = 0.037). A cutoff value of 127.273 HUs was determined to predict mechanical failure, with a sensitivity of 59.1%, specificity of 73.4%, and area under the curve of 0.655 (95% confidence interval: 0.49–0.79). A significant difference in survival was observed between the groups with HU values above and below the cutoff (p = 0.0057). Cement-augmented screws were underutilized, with an average of only 0.2 screws per patient in the F group. Conclusions: Preoperative LIV HU values < 127.273 were strongly associated with an increased risk of mechanical failure following spinal instrumentation without fusion. Alternative surgical strategies including the use of cement-augmented screws are recommended for patients with low HU values. Full article
(This article belongs to the Special Issue Recent Advances in Spine Tumor Diagnosis and Treatment)
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