A Scoring System for Outpatient Orthopedist to Preliminarily Distinguish Spinal Metastasis from Spinal Tuberculosis: A Retrospective Analysis of 141 Patients.
Adult
Aged
Clinical Competence
Diagnosis, Differential
Female
Humans
Logistic Models
Male
Middle Aged
Orthopedic Surgeons
Outpatients
Prospective Studies
Radiographic Image Interpretation, Computer-Assisted
/ methods
Retrospective Studies
Sensitivity and Specificity
Spinal Neoplasms
/ diagnostic imaging
Tuberculosis, Spinal
/ diagnostic imaging
Journal
Disease markers
ISSN: 1875-8630
Titre abrégé: Dis Markers
Pays: United States
ID NLM: 8604127
Informations de publication
Date de publication:
2021
2021
Historique:
received:
30
12
2020
revised:
22
04
2021
accepted:
13
05
2021
entrez:
17
6
2021
pubmed:
18
6
2021
medline:
15
12
2021
Statut:
epublish
Résumé
Spinal tuberculosis (TB) misdiagnosed of spinal metastasis was not rarely reported, especially in outpatients department. This study was aimed to establish an outpatient scoring system to preliminarily distinguish spinal metastasis from spinal TB. We retrospectively reviewed consecutive 141 patients with a pathological diagnosis of spinal metastasis (82 cases) or spinal TB (59 cases) in our hospital from January 2017 to June 2018. The following clinical characteristics which can be obtained by outpatient orthopedist were recorded and analyzed: age, gender, malignant tumor history, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and imaging features including distribution characteristics of vertebral lesions, subligamentous spread, paravertebral or psoas abscess, involved vertebral element, intervertebral disc, and sequestra formation. The prevalence of clinical characteristics in spinal metastasis was evaluated, and the scoring system was established using logistic regression analysis. The performance of the scoring system was also prospectively validated. The outpatient scoring system was based on five clinical characteristics confirmed as significant predictors of spinal metastasis, namely, malignant tumor history, subligamentous spread, posterior element lesions, preserved discs, and no sequestra formation. Spinal metastasis showed a significant higher score than spinal TB (8.17 points Spinal lesions with the score of 5 to 10 would be considered a diagnosis of spinal metastasis, while the score of 0 to 4 may be spinal TB. Because the scoring system is mainly based on the clinical characteristics that can be obtained by an outpatient orthopedist, it is suitable to be used as a diagnostic tool in the outpatient department.
Identifiants
pubmed: 34136021
doi: 10.1155/2021/6640254
pmc: PMC8179772
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6640254Informations de copyright
Copyright © 2021 Xing Du et al.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
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