Evidence map›Paper›PMID 39801123›Full record

ArticleGlobal spine journal2025

Risk Factors for the Development of Neurological Deficits in Metastatic Spinal Disease: An International, Multicenter Delphi Study.

Eline H Huele, Roxanne Gal, Wietse S C Eppinga, Helena M Verkooijen, John E O'Toole, Ilya Laufer, Daniel M Sciubba, Cordula Netzer, Wouter Foppen, Arjun Sahgal and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Global spine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Eline H HueleDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.ORCID 0000-0003-0846-9105
Roxanne GalDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Wietse S C EppingaDepartment of Radiotherapy, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Helena M VerkooijenDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
John E O'TooleDepartment of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
Ilya LauferDivision of Spinal Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, NY, USA.
Daniel M SciubbaDepartment of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA.
Cordula NetzerDepartment of Spine Surgery, University Hospital Basel, Basel, Switzerland.
Wouter FoppenDepartment of Radiology and Nuclear Medicine, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Arjun SahgalDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Michael G FehlingsDivision of Neurosurgery and Spine Program, University of Toronto and Toronto Western Hospital, Toronto, Canada.ORCID 0000-0002-5722-6364
Sheng-Fu L LoDepartment of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA.
Charles G FisherDivision of Spine Surgery, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Laurence D RhinesDepartment of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jeremy J ReynoldsSpinal Division, Oxford University Hospital NHS Trust, Oxford, UK.
Aron LazaryNational Center for Spinal Disorders and Buda Health Center, Budapest, Hungary.ORCID 0000-0002-0157-719X
Alessandro GasbarriniDepartment of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Nicolas DeaDivision of Spine Surgery, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Michael H WeberDepartment of Surgery, McGill University, Montreal, QC, Canada.
Jorrit Jan VerlaanDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designDelphi study.

objectiveThe objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease.

methodsA three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons. In round 1, participants listed radiological factors, patient characteristics, tumor characteristics, previous cancer-related treatment factors and additional factors. In round 2, participants ranked the factors on importance per category and selected a top 9 from all factors. Kendall's W coefficient of concordance was calculated as a measure of consensus. In the final round, participants provided feedback on the rankings resulting from round 2. Lastly, the highest-ranking factors were more clearly defined and operationalized by an expert panel.

resultsOver two hundred physicians and researchers participated in each round. The factors listed in the first round were collapsed into 12 radiological factors, 14 patient characteristics, 6 tumor characteristics and 12 previous cancer-related treatment factors. High agreement was found in round 3 on the top-half lists in each category and the overall top 9, originating from round 2. Kendall's W indicated strong agreement between the participants. 'Epidural spinal cord compression', 'aggressive tumor behavior' and 'mechanical instability' were deemed most influential for the development of neurological deficits.

conclusionThis study provides factors that may be related to the development and/or progression of neurological deficits in patients with metastatic spinal disease. This list can serve as a basis for future directions in prognostication research.

Indexed as

delphimetastatic spinal diseaseneurological deficitsrisk factors

Identifiers

PMID39801123
PMCPMC11726512

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.