Abstract：
METHODS: Retrospective Cohort Study.
OBJECTIVE: Scoring systems for metastatic disease of the spine are used to select patients for surgical treatment based on survival estimation, but it is unknown whether they can be used to predict the outcome of surgery. This study aims to investigate the association between two widely used prognostic scores and the neurologic function after surgery.
METHODS: Retrospective analysis of 204 patients with thoracolumbar metastases treated with decompressive surgery at Karolinska University Hospital (2001-2020). Modified Bauer and Tokuhashi scores were categorized based on surgical indication, and post-operative neurological function was assessed using the Frankel scale at two different post-surgery intervals.
RESULTS: Modified Bauer scores ≥2 yielded higher late follow-up Frankel scores (3.9 ± 1.1) than scores <2 (3.5 ± 1.1), P = .03. Modified Tokuhashi scores ≥9 correlated with higher Frankel scores (4.5 ± .9) than scores <9 (3.5 ± 1.1), P < .0001. Both scoring systems positively predicted neurological outcomes at late follow-up, with odds ratios of 1.6 (P = .03) for Bauer and 9.2 (P < .0001) for Tokuhashi. However, only Tokuhashi predicted ambulatory function at late follow-up (P < .0001), demonstrating its utility in prognosticating post-surgical mobility.
CONCLUSIONS: Higher modified Bauer and Tokuhashi scores were associated with better neurologic function at last follow-up, as well as greater likelihood of being able to walk again. The Tokuhashi score was found to be more accurate than the modified Bauer score in predicting the neurological outcome after surgery.
OBJECTIVE: Scoring systems for metastatic disease of the spine are used to select patients for surgical treatment based on survival estimation, but it is unknown whether they can be used to predict the outcome of surgery. This study aims to investigate the association between two widely used prognostic scores and the neurologic function after surgery.
METHODS: Retrospective analysis of 204 patients with thoracolumbar metastases treated with decompressive surgery at Karolinska University Hospital (2001-2020). Modified Bauer and Tokuhashi scores were categorized based on surgical indication, and post-operative neurological function was assessed using the Frankel scale at two different post-surgery intervals.
RESULTS: Modified Bauer scores ≥2 yielded higher late follow-up Frankel scores (3.9 ± 1.1) than scores <2 (3.5 ± 1.1), P = .03. Modified Tokuhashi scores ≥9 correlated with higher Frankel scores (4.5 ± .9) than scores <9 (3.5 ± 1.1), P < .0001. Both scoring systems positively predicted neurological outcomes at late follow-up, with odds ratios of 1.6 (P = .03) for Bauer and 9.2 (P < .0001) for Tokuhashi. However, only Tokuhashi predicted ambulatory function at late follow-up (P < .0001), demonstrating its utility in prognosticating post-surgical mobility.
CONCLUSIONS: Higher modified Bauer and Tokuhashi scores were associated with better neurologic function at last follow-up, as well as greater likelihood of being able to walk again. The Tokuhashi score was found to be more accurate than the modified Bauer score in predicting the neurological outcome after surgery.
摘要：
方法：回顾性队列研究。
目的：脊柱转移性疾病评分系统用于根据生存评估选择手术治疗的患者，但尚不清楚它们是否可以用来预测手术的结果。本研究旨在探讨两种广泛使用的预后评分与手术后神经功能之间的关系。
方法：回顾性分析在卡罗林斯卡大学医院接受减压手术治疗的204例胸腰椎转移瘤患者（2001-2020年）。修改后的Bauer和Tokuhashi评分根据手术适应症进行分类，术后神经功能使用Frankel量表在两个不同的术后间隔进行评估。
结果：改良的Bauer评分≥2的Frankel晚期随访评分（3.9±1.1）高于<2的评分（3.5±1.1），P=.03。修正德桥得分≥9与Frankel得分（4.5±.9）高于得分<9（3.5±1.1）相关，P<.0001。两种评分系统都能在后期随访时积极预测神经系统结局，Bauer的比值比为1.6(P=.03)，德桥的比值比为9.2(P<.0001)。然而,只有Tokuhashi在后期随访时预测了步行功能（P<0.0001），证明其在预测手术后活动能力方面的效用。
结论：在最后一次随访时，较高的Bauer和Tokuhashi评分与较好的神经功能相关，以及能够再次行走的可能性更大。发现Tokuhashi评分在预测手术后的神经系统结局方面比改良的Bauer评分更准确。
目的：脊柱转移性疾病评分系统用于根据生存评估选择手术治疗的患者，但尚不清楚它们是否可以用来预测手术的结果。本研究旨在探讨两种广泛使用的预后评分与手术后神经功能之间的关系。
方法：回顾性分析在卡罗林斯卡大学医院接受减压手术治疗的204例胸腰椎转移瘤患者（2001-2020年）。修改后的Bauer和Tokuhashi评分根据手术适应症进行分类，术后神经功能使用Frankel量表在两个不同的术后间隔进行评估。
结果：改良的Bauer评分≥2的Frankel晚期随访评分（3.9±1.1）高于<2的评分（3.5±1.1），P=.03。修正德桥得分≥9与Frankel得分（4.5±.9）高于得分<9（3.5±1.1）相关，P<.0001。两种评分系统都能在后期随访时积极预测神经系统结局，Bauer的比值比为1.6(P=.03)，德桥的比值比为9.2(P<.0001)。然而,只有Tokuhashi在后期随访时预测了步行功能（P<0.0001），证明其在预测手术后活动能力方面的效用。
结论：在最后一次随访时，较高的Bauer和Tokuhashi评分与较好的神经功能相关，以及能够再次行走的可能性更大。发现Tokuhashi评分在预测手术后的神经系统结局方面比改良的Bauer评分更准确。
