骨转移会损害椎管的完整性并导致硬膜外脊髓压迫（ESCC）。脊柱不稳定性肿瘤评分 (SINS) 的开发是为了评估肿瘤过程引起的脊柱不稳定性。 SINS 已得到临床医生的广泛接受，但其预后价值仍存在争议。目的是探讨 SINS 和 ESCC 之间的相关性，以及 SINS 与术前下床活动和术后生存之间的关系。评估因脊柱转移瘤接受脊柱手术的患者的 SINS 和 ESCC 分级之间的相关性。 CT和MRI分别用于计算SINS和ESCC分级。通过 Spearman 相关性检验分析相关性。通过 Kaplan-Meier 分析估计术后生存率，并将生存曲线与时序检验进行比较。 Cox 比例风险模型用于评估预后变量的影响，包括年龄、术前下床活动、SINS 和卡诺夫斯基体能状态 (KPS) 作为协变量。该研究包括 256 名患者（196 名男性和 60 名女性），中位年龄70（24-88）岁。平均 SINS 为 10。152 名患者 (59%) 在手术前失去了活动能力。根据 ESCC 量表，101 名患者的等级为 0-2 级，155 名患者的等级为 3 级。 SINS 与 ESCC 分级相关（p = 0.001）。 SINS 评分与术前下床活动无关（p = 0.63）。术后中位生存期为 10 个月，不同 SINS 类别之间的术后生存期没有差异 (p = 0.25)。术前行走能力和较高的 KPS 与较长的术后生存期相关。SINS 与 ESCC 的分级相关，这意味着较高的 SINS 可能被视为发生 ESCC 的风险指标。 SINS 与手术前的行走或手术后的生存无关。© 2024。作者。

Bone metastases can compromise the integrity of the spinal canal and cause epidural spinal cord compression (ESCC). The Spinal Instability Neoplastic Score (SINS) was developed in order to evaluate spinal instability due to a neoplastic process. The SINS has reached wide acceptance among clinicans but its prognostic value is still controversial. The aim was to investigate the correlation between the SINS and ESCC and the association between SINS and ambulation before and survival after surgery.Correlations were assessed between SINS and grades of ESCC in patients who underwent spine surgery for spinal metastases. CT and MRI were used to calculate SINS and the grades of ESCC respectively. Correlations were analyzed with the Spearman's correlation test. Postoperative survival was estimated with Kaplan-Meier analysis and survival curves were compared with the log-rank test. The Cox proportional hazard model was used to assess the effect of prognostic variables including age, ambulation before surgery, SINS, and the Karnofsky Performance Status (KPS) as covariates.The study included 256 patients (196 men and 60 women) with a median age of 70 (24-88) years. The mean SINS was 10. One hundred fifty-two patients (59%) had lost ambulation before surgery. One hundred and one patients had grades 0-2 and 155 patients had grade 3 according to the ESCC-scale. SINS correlated with the grades of ESCC (p = 0.001). The SINS score was not associated with ambulation before surgery (p = 0.63). The median postoperative survival was 10 months, and there was no difference in postoperative survival between the SINS categories (p = 0.25). The ability to walk before surgery and a high KPS were associated with longer postoperative survival.SINS correlated with grades of ESCC, which implies that higher SINS may be considered as an indicator of risk for developing ESCC. The SINS was not associated with ambulation before or survival after surgery.© 2024. The Author(s).