A Scoring System for Outpatient Orthopedist to Preliminarily Distinguish Spinal Metastasis from Spinal Tuberculosis: A Retrospective Analysis of 141 Patients

Autor: Wei Luo, Yong Zhu, Xing Du, Yuxiao She, Dianming Jiang, Yunsheng Ou
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Medicine (General)
Scoring system
Tuberculosis
Article Subject
Clinical Biochemistry
Logistic regression
Sensitivity and Specificity
Diagnosis
Differential
03 medical and health sciences
0302 clinical medicine
R5-920
Outpatients
Genetics
medicine
Outpatient clinic
Humans
Prospective Studies
Abscess
Molecular Biology
Pathological
Aged
Retrospective Studies
030222 orthopedics
Spinal Neoplasms
medicine.diagnostic_test
business.industry
Biochemistry (medical)
Intervertebral disc
General Medicine
Orthopedic Surgeons
Middle Aged
medicine.disease
medicine.anatomical_structure
Logistic Models
Erythrocyte sedimentation rate
Radiographic Image Interpretation
Computer-Assisted
Female
Radiology
Clinical Competence
Tuberculosis
Spinal
business
030217 neurology & neurosurgery
Research Article
Zdroj: Disease Markers, Vol 2021 (2021)
Disease Markers
ISSN: 0278-0240
DOI: 10.1155/2021/6640254
Popis: Objective. 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. Methods. 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. Results. 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 vs. 1.97 points, t = 18.621 , P < 0.001 ), and the optimal cut-off value for the scoring system was 5 points. The sensitivity and specificity of the scoring system for predicting spinal metastasis were 97.85% and 88.33%, respectively, in the validation set. Conclusion. 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.
Databáze: OpenAIRE
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