Razi Journal of Medical Sciences

  Background: Life expectancy of patients with spinal metastasis is an important factor to manage these patients. Tokuhashi is a scoring system which was the sum of the points of six items: 1.general condition, 2. number of extraspinal bone metastasis, 3. number of metastasis in the vertebral body, 4. presence or absence of metastasis to major internal organs, 5. site of the primary lesion, 6. the severity of palsy. This score can predict survival time. Our study is going to evaluate predictive value of Tokuhashi score in order to select more useful treatment for patient with spinal metastases.

  Methods: This study is cohort. We had 109 patients with spinal metastasis that selected from February 2007 to March 2009.Tokuhashi score is determined for all patients. We compare the predicted survival from this score with actual survival. Analysis based on Kaplan_Meier, Cox regression and McNemar tests.

  Results: The predicted survival, based on Tokuhashi score, in 38 patients was less than 6 months, in 39 patients, 6-12 months (, and 1 year or more in 32 patients and the actual survival was: 39 patients died at first 6 months of the follow up, 28 at the second six-month period and 42 patients were alive at the end of the year. No significant difference was seen between predicted and actual Survival time (p=0.116). Present study showed that the Tokuhashi revised scoring system may be practicable and highly predictive preoperative scoring systems for patients with spinal metastases.

  Conclusion: Our study showed the Tokuhashi score system can highly predict the survival of patients with spinal metastasis and it is a trustful tool to use for management of these patients.