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Study Design: Fifty-one patients with spinal multiple myeloma (MM) metastases were operated and followed between January 2004 and July 2014.Objective: The aim of this study was to consider the efficiency of surgical prognosis scores in the management of spinal metastases myelomas.Summary Of Background Data: The spine is the most common site of bone metastases in MM. Surgery in spine metastases MM is a matter of debate and its impact on the increase of a patient's survival time is not clear. Several surgical survival scores have been developed to determine the best treatment in these patients.Methods: We studied 51 patients operated for spinal MM metastases between January 2004 and July 2014. We determined the Tokuhashi and Tomita survival scores and compared them with documented patient survivals. The two scores were also compared with the International Staging System (ISS).Results: Median survival (MS) was 108 months [standard deviation (SD) 62] for ISS I, 132.2 (SD 40) for ISS II, and 45.5 months (SD 16.3) for ISS III (P = 0.09). According to Tokuhashi survival score, 21 patients (41.2%) will survive <6 months, 6 (11.8%) 6 to 12 months, and 24 (47%) >12 months. According to Tomita et al., 50 patients (98%) will survive >49.9 months and 1 patient (2%) <15 months. Regardless of the ISS grade prognosis, Tokuhashi survival score, and to a lesser extent Tomita score, underestimated the actual survival very significantly [P < 0.0001, Log Rank (Mantel-Cox)].Conclusion: We suggest that spine surgical prognosis scores are not accurate and are not able to predict the survival of patients with spine myeloma metastases. Spine surgeons have to be guided not by the initial ISS stage but rather by spinal instability and neurological status.Level Of Evidence: N/A. [ABSTRACT FROM AUTHOR]

Background: Multiple myeloma (MM) is th e most common primary malignant tum or of the spine and bone. Spinal metastases are part of the evolution and progression of the MM disease. Therefore, this study aims at investigating prognostic factors associated with overall survival (OS) in patients with symptomatic spine MM metastases. Methods: Consecutive spine surgery procedures were performed in th e largest series reported to date and comprising 51 patients with osteolytic vertebral compression fractures resulting from MM, diagnosed by e ither bone marrow or tum or biopsy. Results: The mean age of patients was 61.1 years and mean follow-up was 31.9 months. Through univariate analyses, ISS stage (p < 0.0001), preoperative spine instability (SINS score) (p < 0.03), posterior osteosynthesis fixation (p < 0.002), preoperative adjuvant therapy (p < 0.02), postoperative adjuvant tre a tm en t (p < 0.001), bone marrow tran sp lan t (p < 0.03) and newly MM diagnosed (p < 0.03) emerged as powerful predictors of survival. Cox multivariate proportional hazard model indicated that only ISS Stage and stabilization surgery such as osteosynthesis were two in d ependent predictive factors for OS [hazard ratio (HR): 0.268, 95% confidence interval (Cl) 0.0 7 -0 .5 3 6 ; p < 0.006 for the former and HR: 0.184, 95% confidence interval (Cl) 0 .0 3 -0 .8 9 ; p < 0.04 for th e latter]. Conclusion: Stabilization surgery combined to ISS staging should be considered as an imp o rtan t prognostic survival factor for patients with symptomatic MM spine metastases. [ABSTRACT FROM AUTHOR]

Background: Multiple myeloma (MM) is the most common primary malignant tumor of the spine and bone. Spinal metastases are part of the evolution and progression of the MM disease. Therefore, this study aims at investigating prognostic factors associated with overall survival (OS) in patients with symptomatic spine MM metastases. Methods: Consecutive spine surgery procedures were performed in the largest series reported to date and comprising 51 patients with osteolytic vertebral compression fractures resulting from MM, diagnosed by either bone marrow or tumor biopsy. Results: The mean age of patients was 61.1 years and mean follow-up was 31.9 months. Through univariate analyses, ISS stage (p < 0.0001), preoperative spine instability (SINS score) (p < 0.03), posterior osteosynthesis fixation (p < 0.002), preoperative adjuvant therapy (p < 0.02), postoperative adjuvant treatment (p < 0.001), bone marrow transplant (p < 0.03) and newly MM diagnosed (p < 0.03) emerged as powerful predictors of survival. Cox multivariate proportional hazard model indicated that only ISS Stage and stabilization surgery such as osteosynthesis were two independent predictive factors for OS [hazard ratio (HR): 0.268, 95% confidence interval (CI) 0.07e0.536; p < 0.006 for the former and HR: 0.184, 95% confidence interval (CI) 0.03e0.89; p < 0.04 for the latter]. Conclusion: Stabilization surgery combined to ISS staging should be considered as an important prognostic survival factor for patients with symptomatic MM spine metastases. [ABSTRACT FROM AUTHOR]