2026 Volume 17 Issue 2 Pages 95-101
Introduction: Spinal metastases in cancer patients can lead to severe pain and paralysis from skeletal-related events (SREs). As the time to SRE onset is relatively short based on previous reports, early detection and prompt treatment are crucial. We developed a medical system where radiologists immediately notify spine surgeons of suspected spinal metastases found on imaging scans (positron emission tomography, computed tomography, magnetic resonance imaging). In addition, spine surgeons evaluate imaging results and refer such cases to cancer treatment doctors. The purpose of this study was to clarify the time delays 1) from diagnosis to orthopedic referral and 2) from referral to treatment initiation. Furthermore, we evaluated the burden to spine surgeons based on the number of spinal metastatic tumor per month.
Methods: We recruited 43 cases identified by this system between October 2021 and December 2023. Of those, 36 cases were referred to our department via cancer treatment doctors. We evaluated time delays of the three treatment methods, such as surgery, radiotherapy and bone modifying agents, for spinal metastatic tumor.
Results: The median time from imaging diagnosis to orthopedic referral was 7 days. The median time from referral to treatment initiation was 21 days, although there were no statistically significant differences in time delays among the three treatment methods. The system generated an average of two referrals per month.
Conclusions: Our system effectively facilitates early detection and referral of spinal metastases, although challenges remain in shortening the time to treatment initiation. We also concluded that the burden on spine surgeons when this system was introduced was not excessive.
