TY - JOUR
T1 - Risk Factors for the Development of Neurological Deficits in Metastatic Spinal Disease
T2 - An International, Multicenter Delphi Study
AU - Huele, Eline H.
AU - Gal, Roxanne
AU - Eppinga, Wietse S.C.
AU - Verkooijen, Helena M.
AU - O’Toole, John E.
AU - Laufer, Ilya
AU - Sciubba, Daniel M.
AU - Netzer, Cordula
AU - Foppen, Wouter
AU - Sahgal, Arjun
AU - Fehlings, Michael G.
AU - Lo, Sheng fu L.
AU - Fisher, Charles G.
AU - Rhines, Laurence D.
AU - Reynolds, Jeremy J.
AU - Lazary, Aron
AU - Gasbarrini, Alessandro
AU - Dea, Nicolas
AU - Weber, Michael H.
AU - Verlaan, Jorrit Jan
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2025/1
Y1 - 2025/1
N2 - Study Design: Delphi study Objective: The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease. Methods: A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons. In round 1, participants listed radiological factors, patient characteristics, tumor characteristics, previous cancer-related treatment factors and additional factors. In round 2, participants ranked the factors on importance per category and selected a top 9 from all factors. Kendall’s W coefficient of concordance was calculated as a measure of consensus. In the final round, participants provided feedback on the rankings resulting from round 2. Lastly, the highest-ranking factors were more clearly defined and operationalized by an expert panel. Results: Over two hundred physicians and researchers participated in each round. The factors listed in the first round were collapsed into 12 radiological factors, 14 patient characteristics, 6 tumor characteristics and 12 previous cancer-related treatment factors. High agreement was found in round 3 on the top-half lists in each category and the overall top 9, originating from round 2. Kendall’s W indicated strong agreement between the participants. ‘Epidural spinal cord compression’, ‘aggressive tumor behavior’ and ‘mechanical instability’ were deemed most influential for the development of neurological deficits. Conclusion: This study provides factors that may be related to the development and/or progression of neurological deficits in patients with metastatic spinal disease. This list can serve as a basis for future directions in prognostication research.
AB - Study Design: Delphi study Objective: The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease. Methods: A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons. In round 1, participants listed radiological factors, patient characteristics, tumor characteristics, previous cancer-related treatment factors and additional factors. In round 2, participants ranked the factors on importance per category and selected a top 9 from all factors. Kendall’s W coefficient of concordance was calculated as a measure of consensus. In the final round, participants provided feedback on the rankings resulting from round 2. Lastly, the highest-ranking factors were more clearly defined and operationalized by an expert panel. Results: Over two hundred physicians and researchers participated in each round. The factors listed in the first round were collapsed into 12 radiological factors, 14 patient characteristics, 6 tumor characteristics and 12 previous cancer-related treatment factors. High agreement was found in round 3 on the top-half lists in each category and the overall top 9, originating from round 2. Kendall’s W indicated strong agreement between the participants. ‘Epidural spinal cord compression’, ‘aggressive tumor behavior’ and ‘mechanical instability’ were deemed most influential for the development of neurological deficits. Conclusion: This study provides factors that may be related to the development and/or progression of neurological deficits in patients with metastatic spinal disease. This list can serve as a basis for future directions in prognostication research.
KW - delphi
KW - metastatic spinal disease
KW - neurological deficits
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85215502381&partnerID=8YFLogxK
U2 - 10.1177/21925682231222424
DO - 10.1177/21925682231222424
M3 - Article
AN - SCOPUS:85215502381
SN - 2192-5682
VL - 15
SP - 93S-103S
JO - Global Spine Journal
JF - Global Spine Journal
ER -