Introduction:Metastatic spinal cord compression (MSCC) is a life-threatening complication caused by the involvement of the spinal cord or nerve roots. It can result in severe neurological deficits, including paralysis, sensory loss, and bladder or bowel dysfunction, significantly affecting patients’ quality of life. Prompt diagnosis and intervention are critical to minimizing these outcomes and improving neurological recovery. This study evaluates the efficacy of a diagnostic and therapeutic protocol introduced at our institution in 2022, designed to enhance early detection, optimize management, and improve outcomes for patients with MSCC.Materials and Methods:The protocol was developed through a multidisciplinary collaboration involving emergency physicians, oncologists, spine surgeons, neuroradiologists, and radiation oncologists. Each specialty contributed its expertise to create a streamlined approach emphasizing early symptom recognition, rapid diagnostic imaging, and timely therapeutic interventions, such as surgical decompression and radiotherapy. To assess the protocol’s effectiveness, a retrospective analysis was conducted. Clinical data from the pre-implementation period (years 2019–2021) were compared to the post-implementation period (2022–2024).Results:The implementation of the algorithm significantly improved MSCC management, increasing outpatient consultations from 671 to 828 (+23%). Comparing the pre- to post-implementation periods, emergency consultations rose from 14% to 23%, while intrahospital consultations decreased from 20% to 16%. Surgical procedures increased slightly, from 60 to 66 (+10%), including 26 emergency surgeries (+4%) and 40 elective delayed surgeries (+14%).Conclusions:The introduction of a multidisciplinary diagnostic and therapeutic protocol significantly improved outpatient management of patients with metastatic spine disease, demonstrated by a significant increase in urgent outpatient consultations and a reduction in intrahospital consultations. The number of surgical interventions for metastatic spinal cord compression slightly increased after the protocol’s adoption, although the proportion of elective surgeries remained unchanged. Neurological presentation at the time of surgery did not show a statistically significant difference between the pre- and post-implementation periods. These findings highlight the protocol’s effectiveness in optimizing patient flow and triaging, while further research is needed to evaluate its long-term clinical impact.
引言：转移性脊髓压迫症（MSCC）是一种危及生命的并发症，由脊髓或神经根受累引起。它可导致严重的神经功能缺损，包括瘫痪、感觉丧失以及膀胱或肠道功能障碍，严重影响患者的生活质量。及时诊断和干预对于减少这些不良后果、促进神经功能恢复至关重要。本研究评估了本机构于2022年引入的诊断与治疗方案的疗效，该方案旨在加强MSCC患者的早期发现、优化管理并改善临床结局。 材料与方法：该方案通过多学科协作制定，参与科室包括急诊科医师、肿瘤科医师、脊柱外科医师、神经放射科医师及放射肿瘤科医师。各专科发挥专业优势，共同构建了一套强调早期症状识别、快速影像学诊断以及及时采取手术减压和放疗等治疗干预措施的标准化流程。为评估方案效果，研究进行了回顾性分析，比较了方案实施前（2019-2021年）与实施后（2022-2024年）的临床数据。 结果：该流程的实施显著改善了MSCC的管理，门诊会诊量从671例增加至828例（+23%）。比较实施前后，急诊会诊比例从14%上升至23%，而院内会诊比例从20%下降至16%。手术量小幅增加，从60例增至66例（+10%），其中急诊手术26例（+4%），择期延迟手术40例（+14%）。 结论：多学科诊断与治疗方案的引入显著改善了转移性脊柱疾病患者的门诊管理，表现为紧急门诊会诊量显著增加而院内会诊量减少。方案实施后，针对转移性脊髓压迫症的手术干预数量略有增加，但择期手术比例未发生改变。手术时的神经功能表现在实施前后未显示出统计学显著差异。这些结果凸显了该方案在优化患者分流与分诊方面的有效性，但其长期临床影响仍需进一步研究评估。
肿瘤(癌症)患者之家