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Spine

EVOLUTION OF A REFERRAL PROCESS AND DATA COLLATION SYSTEM FOR METASTATIC SPINAL CORD COMPRESSION

Britspine, British Scoliosis Society (BSS), Society for Back Pain Research (SBPR), British Association of Spine Surgeons (BASS)



Abstract

To describe the development of a system of referral, initial data acquisition and subsequent database recording and outcome reporting for metastatic spinal cord compression.

Deficiencies in the literature identified by the NICE GDG for MSCC for research were compared with our original database and modifications made to ensure prospective collection of currently recognised and some proposed relevant factors.

In addition modifications were made to ensure that all NICE implementation audit data and “target “ data are recorded and can be seamlessly transferred to necessary destinations

This generates standardised reports of the presentation, management and longitudinal interval outcomes including analogue pain scales, analgesic requirement, neurological function, Karnofsky performance indices, Euroquols, and ODIs. It includes pretreatment prognostic indices (updated 2005 Tokuhashi scores) relevant to treatment selection and scale of surgical intervention. Outcomes can be subclassified by type of intervention relative to clinical status at intervention

In house live assessment has revealed some reducing minor operational flaws and initial external assessment is current.

A comprehensive information system and treatment guide for this increasing group has been developed and is evolving. Common adoption would facilitate earlier recognition and optimise treatment to diminish the high human and financial cost of MSCC. Currently networks are setting up NSSGs and for this process to be enhanced and to avoid costly duplication adoption of this system modified following peer review is suggested.