PDF(Pubmed)
Abstract：
OBJECTIVE: Precise assessment of spinal instability is critical before and after radiotherapy (RT) for evaluating the effectiveness of RT. Therefore, we retrospectively evaluated the efficacy of RT in spinal instability over a period of 6 months after RT, utilizing the spinal instability neoplastic score (SINS) in patients with painful spinal metastasis. We retrospectively evaluated 108 patients who received RT for painful vertebral metastasis in our institution. Mechanical pain at metastatic vertebrae, radiological responses of irradiated vertebrae, and spinal instability were assessed. Follow-up assessments were done at the start of and at intervals of 1, 2, 3, 4, and 6 months after RT, with the pain disappearing in 67%, 85%, 93%, 97%, and 100% of the patients, respectively. The median SINS were 8, 6, 6, 5, 5, and 4 at the beginning and after 1, 2, 3, 4, and 6 months of RT, respectively. Multivariate analysis revealed that posterolateral involvement of spinal elements (PLISE) was the only risk factor for continuous potentially unstable/unstable spine at 1 month. In conclusion, there was improvement of pain, and recalcification results in regaining spinal stability over time after RT although vertebral body collapse and malalignment occur in some irradiated vertebrae. Clinicians should pay attention to PLISE in predicting continuous potentially unstable/unstable spine.
摘要：
目的：精确评估脊柱不稳定在放疗（RT）前后对评价RT的有效性至关重要。因此,我们回顾性评估了RT治疗脊柱不稳定的疗效，在疼痛性脊柱转移患者中利用脊柱不稳定肿瘤评分（SINS）。我们回顾性评估了108例接受RT治疗的椎体疼痛性转移患者。转移性椎骨的机械性疼痛，辐射椎骨的放射学反应，和脊柱不稳定进行评估。在RT开始时以及在RT后1、2、3、4和6个月的间隔进行随访评估，67%的人疼痛消失，85%,93%,97%,100%的病人,分别。在RT开始和1、2、3、4和6个月后，中位数SINS分别为8、6、6、5、5和4，分别。多因素分析显示，脊柱后外侧受累（PLISE）是1个月时脊柱持续潜在不稳定/不稳定的唯一危险因素。总之,疼痛有所改善，尽管在某些辐照的椎骨中会发生椎体塌陷和对齐不良，但随着时间的推移，重新钙化会导致脊柱稳定性恢复。临床医生在预测持续的潜在不稳定/不稳定脊柱时应注意PLISE。
