• Giuseppe Di Perna, Bianca Baldassarre, Daniele Armocida, Raffaele De Marco, Alessandro Pesaresi, Serena Badellino, Marco Bozzaro, Salvatore Petrone, Lucio Buffoni, Cristina Sonetto, Emmanuele De Luca, Davide Ottaviani, Fulvio Tartara, Francesco Zenga, Marco Ajello, Nicola Marengo, Michele Lanotte, Roberto Altieri, Francesco Certo, Alessandro Pesce, Angelo Pompucci, Alessandro Frati, Umberto Ricardi, Giuseppe Maria Barbagallo, Diego Garbossa, and Fabio Cofano.
• Spine Surgery Unit, Casa di Cura Città di Bra, Bra, Italy.
• Eur Spine J. 2024 Nov 1; 33 (11): 430243154302-4315.

PurposeThis retropective multicentric study aims to investigate the clinical applicability of the NSE score in the elderly, to verify the role of this tool as an easy help for decision making also for this class of patients.MethodsAll elderly patients (> 65 years) suffering from spinal metastases undergoing surgical or non-surgical treatment at the authors' Institutions between 2015 and 2022 were recruited. An agreement group (AG) and non-agreement group (NAG) were identified accordingly to the agreement between the NSE score indication and the performed treatment. Neurological status and axial pain were evaluated for both groups at follow-up (3 and 6 months). The same analysis was conducted specifically grouping patients older than 75 years.ResultsA strong association with improvement or preservation of clinical status (p < 0.001) at follow-up was obtained in AG. The association was not statistically significant in NAG at the 3-month follow-up (p 1.00 and 0.07 respectively) and at 6 months (p 0.293 and 0.09 respectively). The group of patients over 75 years old showed similar results in terms of statistical association between the agreement group and better outcomes.ConclusionFar from the need or the aim to build dogmatic algorithms, the goal of preserving a proper performance status plays a key role in a modern oncological management: functional outcomes of the multicentric study group showed that the NSE score represents a reliable tool to establish the need for surgery also for elderly patients.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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