The Oswestry Risk Index: An aid in the treatment of metastatic disease of the spine

Balain, B.; Jaiswal, A.; Trivedi, J. M.; Eisenstein, S. M.; Kuiper, J. H.; Jaffray, D. C.

Abstract

The revised Tokuhashi, Tomita and modified Bauer scores are commonly used to make difficult decisions in the management of patients presenting with spinal metastases. A prospective cohort study of 199 consecutive patients presenting with spinal metastases, treated with either surgery and/or radiotherapy, was used to compare the three systems. Cox regression, Nagelkerke’s R2 and Harrell’s concordance were used to compare the systems and find their best predictive items. The three systems were equally good in terms of overall prognostic performance. Their most predictive items were used to develop the Oswestry Spinal Risk Index (OSRI), which has a similar concordance, but a larger coefficient of determination than any of these three scores. A bootstrap procedure was used to internally validate this score and determine its prediction optimism.

The OSRI is a simple summation of two elements: primary tumour pathology (PTP) and general condition (GC): OSRI = PTP + (2 – GC).

This simple score can predict life expectancy accurately in patients presenting with spinal metastases. It will be helpful in making difficult clinical decisions without the delay of extensive investigations.

Citation

Balain, B., Jaiswal, A., Trivedi, J. M., Eisenstein, S. M., Kuiper, J. H., & Jaffray, D. C. (2013). The Oswestry Risk Index: An aid in the treatment of metastatic disease of the spine. The Bone & Joint Journal, 95-B(2), 210-216. https://doi.org/10.1302/0301-620x.95b2.29323

• Journal Article Type: Article
• Acceptance Date: Dec 5, 2012
• Online Publication Date: Feb 1, 2013
• Publication Date: 2013-02
• Deposit Date: Jun 13, 2023
• Journal: The Bone & Joint Journal
• Print ISSN: 2049-4394
• Electronic ISSN: 2049-4408
• Publisher: British Editorial Society of Bone and Joint Surgery
• Peer Reviewed: Peer Reviewed
• Volume: 95-B
• Issue: 2
• Pages: 210-216
• DOI: https://doi.org/10.1302/0301-620x.95b2.29323
• Keywords: Orthopedics and Sports Medicine; Surgery
• Additional Information: Received: 2012-02-05; Accepted: 2012-12-05; Published: 2013-02-01