Metastatic Bone Disease
A 65-year-old man with known metastatic lung cancer presents with progressive thoracic back pain and new bilateral leg weakness over 2 weeks. MRI shows a T8 vertebral body lesion with epidural extension causing high-grade cord compression. CT demonstrates a lytic lesion with more than 50% vertebral body collapse. He can still ambulate with assistance. The oncology team asks for orthopaedic assessment regarding spinal stability and surgical options. His estimated survival is 6-12 months with ongoing systemic therapy. Regarding metastatic spine disease assessment and management:
Mark each as TRUE or FALSE
The SINS (Spinal Instability Neoplastic Score) assesses stability: 0-6 = STABLE; 7-12 = INDETERMINAT...
The NOMS framework guides treatment: N = Neurologic status (Bilsky ESCC grade); O = Oncologic factor...
SINS score of 5 indicates instability requiring urgent surgery; ALL spinal metastases require surgic...
BILSKY grading for epidural spinal cord compression (ESCC): Grade 0 = bone only; Grade 1a/1b/1c = ep...
Common spine metastasis primaries: BPLTK (Breast, Prostate, Lung, Thyroid, Kidney); breast and prost...
Answer the questions to see explanations
Click T (True) or F (False) for each option