OBJECTIVE The aim of this study was to translate new evidence about management of spinal metastases in a practical and reliable score for surgeons, radiation oncologists and oncologists, able to establish the need for surgery regardless the available technology and settings. PATIENTS AND METHODS Three main items were identified and graded: Neurological status (0-5 points), Stability of the spine according to the Spinal Instability Neoplastic Score (SINS) Score (0-5 points), and Epidural compression according to the Epidural Spinal Cord Compression (ESCC) scale (0-3 points). Patients were considered suitable for surgery with ASA score < 4 and ECOG score <3. A retrospective clinical validation of the NSE score was made on 145 patients that underwent surgical or non surgical treatment. RESULTS Agreement between the undertaken treatment and the score (88.3% of patients), resulted in a strong association with improvement or preservation of clinical status (neurological functions and mechanical pain) (p < 0.001) at 3 and 6 months. In the non-agreement group no association was recorded at the 3 and 6 months follow-up (p 0.486 and 0.343 for neurological functions, 0.063 and 0.858 for mechanical pain). CONCLUSION Functional outcomes of the study group showed that the proposed NSE score could represent a practical and reliable tool to establish the need for surgery. Agreement between the score and the performed treatments resulted in better clinical outcomes, when compared with patients without agreement. Further validation is needed with a larger number of patients and to assess reproducibility among surgeons, radiation oncologists, and oncologists.

中文翻译：

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神经学-稳定性-硬膜外压迫评估：确定脊柱转移瘤手术需求的新评分

目的 本研究的目的是将有关脊柱转移瘤管理的新证据转化为实用且可靠的评分，以供外科医生、放射肿瘤学家和肿瘤学家使用，无论可用的技术和环境如何，都能确定是否需要手术。患者和方法 确定并分级了三个主要项目：神经学状态（0-5 分）、根据脊柱不稳定性肿瘤评分 (SINS) 评分的脊柱稳定性（0-5 分）和根据硬膜外脊髓的硬膜外压迫脐带压缩 (ESCC) 量表（0-3 分）。ASA评分<4且ECOG评分<3的患者被认为适合手术。对 145 名接受手术或非手术治疗的患者进行了 NSE 评分的回顾性临床验证。结果 所进行的治疗与评分（88.3% 的患者）之间的一致性与临床状态（神经功能和机械疼痛）的改善或保持密切相关（p < 0.001）在 3 个月和 6 个月。在不同意组中，在 3 个月和 6 个月的随访中没有记录到相关性（神经功能的 p 分别为 0.486 和 0.343，机械疼痛的 p 为 0.063 和 0.858）。结论 研究组的功能结果表明，建议的 NSE 评分可以代表确定手术需求的实用且可靠的工具。与没有一致意见的患者相比，评分和所进行的治疗之间的一致导致更好的临床结果。需要对更多患者进行进一步验证，并评估外科医生之间的可重复性，