• Aymeric Amelot, Joseph Cristini, Céline Salaud, Alexis Moles, Olivier Hamel, Philippe Moreau, Eric Bord, and Kevin Buffenoir.
• *Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France †Department of Haematology, Nantes University Hospital, France.
• Spine. 2016 Jul 7.

Study DesignFifty-one patients with spinal multiple myeloma (MM) metastases were operated and followed between January 2004 and July 2014.ObjectiveTo consider the efficiency of surgical prognosis scores in the management of spinal metastases myelomas SUMMARY OF BACKGROUND DATA.: The spine is the most common site of bone metastases in Multiple Myeloma (MM). Surgery in spine metastases MM is a matter of debate and its impact on the increase of a patient's survival time is not clear. Several surgical survival scores have been developed to determine the best treatment in these patients.MethodsWe studied 51 patients operated for spinal MM metastases between January 2004 and July 2014. We determined the Tokuhashi and Tomita survival scores and compared them with documented patient survivals. The 2 scores were also compared with the International Staging System (ISS).ResultsMedian survival (MS) was 108 months (SD 62) for ISS I, 132.2 (SD 40) for ISS II and 45.5 months (SD 16.3) for ISS III (p = 0.09). According to Tokuhashi survival score 21 patients (41.2%) will survive < 6 months, 6 (11.8%) 6-12 months, and 24 (47%) > 12 months. According to Tomita el al. 50 patients (98%) will survive > 49.9 months, and 1 patient (2%) < 15 months. Regardless of the ISS grade prognosis, Tokuhashi survival score and to a lesser extent Tomita score underestimated very significantly the actual survival ((p < 0.0001, Log Rank (Mantel-Cox)).ConclusionsWe suggest that spine surgical prognosis scores are not accurate and are not able to predict the survival of patients with spine myeloma metastases. Spine surgeons have to be guided not by the initial ISS stage but rather by spinal instability and neurological status.Level Of EvidenceN/A.

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