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Role of Denosumab in Patients with Intermediate Spinal Instability Neoplastic Score (SINS)

  • 0Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehangro, Jongrogu, Seoul 03080, Republic of Korea.
Cancers +

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May 14, 2025

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May 14, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Denosumab treatment reduced the need for surgery in patients with impending spinal instability from metastasis. This approach also improved the Spinal Instability Neoplastic Score (SINS) and Hounsfield unit (HU) values.

Area Of Science

  • Oncology
  • Orthopedic Surgery
  • Radiology

Background

  • Spinal metastasis can lead to impending instability, necessitating interventions.
  • The Spinal Instability Neoplastic Score (SINS) is used to assess the risk of instability.
  • Non-operative management is the initial approach for intermediate SINS lesions.

Purpose Of The Study

  • To evaluate denosumab's effect on impending spinal instability caused by metastasis.
  • To determine if denosumab improves SINS and reduces surgical intervention rates.
  • To assess changes in Hounsfield units (HU) as a measure of bone density.

Main Methods

  • Retrospective review of patients with intermediate SINS (7-12) treated non-operatively.
  • Comparison between denosumab (D-group) and no denosumab (N-group) cohorts.
  • Propensity score matching (PSM) used to control for confounding variables; outcomes included surgery conversion rate, SINS, and HU changes.

Main Results

  • After PSM, the denosumab group showed a significantly lower rate of conversion to surgery (8.3% vs. 16.6%).
  • Kaplan-Meier analysis confirmed a lower probability of surgery in the denosumab group (p=0.023).
  • Denosumab treatment led to significant improvements in SINS and HU values.

Conclusions

  • Denosumab effectively lowers the rate of surgical intervention in patients with impending spinal instability due to metastasis.
  • Denosumab treatment improves SINS and bone density (HU) in patients with metastatic spinal lesions.
  • Denosumab is a valuable therapeutic option for managing spinal metastasis with impending instability.

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