Neurological and Survival Outcomes After Surgical Management of Subaxial Cervical Spine Metastases
Bibliographic record
Abstract
STUDY DESIGN: A clinical retrospective study. OBJECTIVE: To investigate the clinical outcomes of surgery for cervical spine metastasis and identify factors affecting survival and neurological result. SUMMARY OF BACKGROUND DATA: Metastatic disease in the cervical spine is known to be a poorer prognosis than in thoracic and lumbar regions. Few reports focused on cervical spine metastasis are available. METHODS: A retrospective analysis of medical records and radiological data was performed on 46 patients who underwent surgical treatment due to cervical spine metastasis from 2000 to 2010. The incidence of cervical metastasis, overall survival, progression-free survival, and neurological and pain outcomes were analyzed. In addition, factors affecting survival, local recurrence, and neurological and pain outcomes among the 46 study subjects were analyzed. These factors included; age, sex, primary tumor growth rate, preoperative disease-progression status (expressed with Tomita score), irradiation, timing of irradiation, postoperative adjuvant therapy, time of diagnosis of spinal metastasis, cord compression or foraminal invasion on magnetic resonance image, preoperative neurological status, and preoperative pain level. RESULTS: The incidence of cervical metastasis was 17.3%. Mean postoperative overall survival was 16.89 months, the recurrence rate was 39.1%, and mean progression free survival was 11.82 months. Factors related to prolonged survival were slow primary tumor growth, low Tomita score, irradiation of the lesion, and postoperative adjuvant therapy. Postoperative adjuvant therapy was also found to be effective for preventing recurrence. Patients with high preoperative Japanese Orthopaedic Association Score achieved better neurological outcomes. Foraminal invasion was found to be negatively correlated with postoperative pain outcome. CONCLUSION: Surgical management for subaxial cervical spinal metastasis was found to be effective in terms of neurological recovery and pain control. Furthermore, surgical treatment plus adjuvant therapy was found to achieve sufficient local control during postoperative follow-up.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".