SADA-13 TOWARD CONSENSUS: DEFINING OPTIMAL SURGICAL OUTCOMES IN METASTATIC SPINE DISEASE
Andrew Hardigan, Rafael de la Garza Ramos, Michael Weber, Mark Pahuta, Shalin S Patel, Mark MacLlean, Arjun Sahgal, Laurence D Rhines, Daniel M Sciubba, Cordula Netzer, Nicholas Dea, Jorrit-Jan Verlaan, Alessandro Gasbarrini, Jeremy Reynolds, Ori Barzilai, Chetan Bettegowda, Stefano Boriani, Charles Fisher, Ziya L Gokaslan, Aron Lazary, Ilya Laufer, John Shin, Raphaële Charest-Morin, C Rory GoodwinAbstract
Introduction
Given the palliative nature of treatment for metastatic spine disease (MSD), measuring surgical outcomes in this population requires examining comprehensive outcome variables. We sought to achieve an international consensus in how to measure success in the MSD population.
Methods
The AO Spine Knowledge Forum Tumor, consisting of dedicated spine oncology specialists, participated in a modified Delphi process between March 2023 and November 2024. The two part study asked which outcome variables were important to include in a composite outcome as well as what metrics would define a successful outcome.
Results
A total of 42 spine oncology surgeons and oncologists across North America, Latin America, Europe, and Asia participated. Over 90% of participants agreed or strongly agreed that composite measures should be used to assess the quality of surgical care when treating patients with MSD. Three outcome variables were selected to define a successful outcome as defined by the OSCO-M: the absence of a Spinal Adverse Events Severity System, Version 2 grade 3 adverse events or higher, maintaining or improving ECOG performance status at 90 days, and being ambulatory at 90 days.
Conclusion
This is the first study defining a composite measure outcome in oncologic surgery for spinal metastases derived from an international group of surgeons and oncologists who treat patients for MSD. The OSCO-M will be useful for defining clinical success in patients undergoing treatment for MSD.