Yao XC, Shi XJ, Xu ZY, Tan J, Wei YZ, Qi L, Zhou ZH, Du XR. Preliminary establishment of a spinal stability scoring system for multiple myeloma. World J Clin Cases 2021; 9(30): 9023-9037 [PMID: 34786385 DOI: 10.12998/wjcc.v9.i30.9023]
Corresponding Author of This Article
Xin-Ru Du, PhD, Professor, Department of Orthopedic, Beijing Chaoyang Hospital, Gongren Tiyuguan Nanlu No. 8, Beijing 100020, China. duxinru@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2021; 9(30): 9023-9037 Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9023
Table 1 Basic characteristics of the experts
Content
n (%)
Gender
Males
11 (73)
Females
4 (27)
Age (yr)
31-40
6 (40)
41-50
3 (20)
≥ 50
6 (40)
Engaged in medical care time (yr)
≤ 10
3 (20)
11-20
5 (33)
> 20
7 (47)
Educational background
Bachelor‘s degree
4 (27)
Master’s degree
4 (27)
doctorate
7 (46)
Professional titles
Attending
5 (33)
Associate chief of doctor
4 (27)
Chief of doctor
6 (40)
Table 2 The expert scores from the second round of the consultations
First-level indices
Second-level indices
mean ± SD
CV%
Location
Junctional
4.87 ± 0.34
0.07
Mobile
4.47 ± 0.50
0.11
Semirigid
3.53 ± 0.62
0.17
Rigid
3.07 ± 0.44
0.14
Lesion-free
2.47 ± 0.81
0.33
Level of pain
Recalcitrant pain in the corresponding zone (not relieved after chemotherapy) VAS > 7
4.80 ± 0.40
0.08
Moderate pain in the corresponding zone (not relieved after chemotherapy) VAS 4-7
4.47 ± 0.49
0.11
Mild pain in the corresponding zone (VAS = 3 after chemotherapy)
3.67 ± 0.48
0.13
Mild pain during activity (VAS ≤ 2 after chemotherapy) no rest pain
3.20 ± 0.40
0.12
No pain during activity after chemotherapy
2.67 ± 0.94
0.35
Number of segments
> 3
4.93 ± 0.25
0.05
3
4.87 ± 0.56
0.11
2
4.67 ± 0.79
0.17
1
3.80 ± 0.99
0.26
No change in morphology
2.73 ± 0.10
0.36
physiological curvature
Lateral radiograph
Physiological curvature of the lesion is abnormal
4.67 ± 0.47
0.10
Physiological curvature of the lesion is normal
3.00 ± 0.52
0.17
Front radiograph
Scoliosis/rotation
4.80 ± 0.40
0.08
No scoliosis/rotation
3.00 ± 0.52
0.17
Comorbidities
Spondylolisthesis ( 1 degree)
4.87 ± 0.34
0.07
Shift/dislocation (0-1degree)
4.53 ± 0.62
0.14
Herniated disk
3.93 ± 0.44
0.11
Bone spurs
3.13 ± 0.50
0.16
Bony fusion
2.80 ± 0.54
0.19
Neurological function
Frankel A
5.00 ± 0.00
0.00
Frankel B
4.87 ± 0.34
0.07
Frankel C
4.73 ± 0.44
0.09
Frankel D
4.07 ± 0.25
0.06
Frankel E
2.87 ± 0.34
0.12
Table 3 The location score and its secondary index score
Location
Score
Junctional
4
Occipitocervical region (C1-C2)
Cervicothoracic region (C7-T2)
Thoracolumbar region (T11-L1)
Lumbosacral region (L5-S1)
Mobile
3
Cervical vertebra (C3-C7)
Lumbar vertebra (L2-L4)
Semirigid (T3-T10)
2
Rigid (S2-S5)
1
Lesion-free
0
Table 4 The pain score and its secondary index score
Pain
Score
Intractable pain (not alleviated by bed rest/chemotherapy, VAS > 7)
4
Moderate pain (not alleviated by bed rest/chemotherapy, VAS 4-7)
3
Mild pain (After bed rest/chemotherapy, VAS = 3)
2
Slight pain after activity (VAS ≤ 2) no pain when resting
1
No pain during physical activity after chemotherapy
0
Table 5 The number of segments score and its secondary index score
Number of segments
Score
> 3
4
3
3
2
2
1
1
No change in morphology
0
Table 6 The physiological curvature score and its secondary index score
Physiological curvature
Score
Lateral radiograph
Physiological curvature of the lesion is abnormal
2
Physiological curvature of the lesion is normal
0
Front radiograph
Scoliosis/rotation
2
No scoliosis/rotation
0
Table 7 The comorbidities score and its secondary index score
Comorbidities
Score
Spondylolisthesis (> 1 degree)
4
Shift/dislocation (0-1 degree)
3
Herniated disk
2
Bone spurs
1
Bony fusion
0
Table 8 The neurological function score and its secondary index score
Neurological function (according to the Frankel classification)
Score
Frankel A
4
Frankel B
3
Frankel C
2
Frankel D
1
Frankel E
0
Table 9 Results of the multiple myeloma spinal stability scoring system and Spinal Instability Neoplastic Score by R-R paired chi-square test
SINS
McNemar-Bowker
P value
MM
Stable
Potentially unstable
Unstable
Total
38.105
0.000
Stable
5
37
3
45
Potentially unstable
1
21
3
25
Unstable
0
1
1
2
Total
6
59
7
72
Citation: Yao XC, Shi XJ, Xu ZY, Tan J, Wei YZ, Qi L, Zhou ZH, Du XR. Preliminary establishment of a spinal stability scoring system for multiple myeloma. World J Clin Cases 2021; 9(30): 9023-9037