title: Predictive value of Tokuhashi and Tomita scores in patients with metastatic spine disease.
abstract: OBJECTIVE
  Our aim was to determine the best preoperative prognostic score to safely propose operative intervention for patients with metastatic spinal disease.
  
  
  METHODS
  This prospective cohort study included 52 consecutive patients who underwent surgery between 1997 and 2007 to alleviate pain and preserve or restore neurological function. All patients were prospectively evaluated with the Tokuhashi score and retrospectively with the Tomita score to compare their surgery indications. The relationship between the scores and overall survival time were compared. P values of less than 0.05 were considered significant.
  
  
  RESULTS
  In predicting survival time, the Tokuhashi score was statistically significant (r=0.574, p=0.01), and the Tomita score borderline significant (r=-0.394, p=0.05). For overall survival after initial diagnosis, the Tokuhashi score was borderline significant for survival (r=0.380, p=0.05) and the Tomita score was not significant.
  
  
  CONCLUSIONS
  The prognostic Tokuhashi score appears to be more valuable for surgical indications than the Tomita score in patients with spinal metastases.
authors.affiliation: Unit for Spinal Surgery, Department of Trauma and Orthopedic Surgery, James Cook University Hospital, Middlesbrough, England, UK.
authors.forename: Sotiris
authors.initials: S
authors.lastname: Papastefanou
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Alpantaki
authors.forename: Gabriel
authors.initials: G
authors.lastname: Akra
authors.forename: Pavlos
authors.initials: P
authors.lastname: Katonis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome