Ramazanoglu et al reported an algorithm for managing a patient with a spinal lymphoma. The authors are from Health Sciences University and VM Medical Park Maltepe Hospital in Istanbul, Turkey.
Patient selection: spinal lymphoma
The patient evaluation includes:
(1) ASIA scale
(2) modified McCormick scale
(3) Spinal Instability Neoplastic Score (SINS)
Parameters:
(1) presence of moderate to severe neurodeficit and/or vertebral instability
(2) acute or chronic course
(3) osteolytic change
Neurodeficit or Instability
Course
Osteolytic Change
Action
yes
chronic
NA
elective decompression and stabilization
yes
acute
NA
emergency decompression and stabilization
no
NA
yes
vertebroplasty
no
NA
no
All patients require a percutaneous tumor biopsy. If the patient requires emergency surgery then it is performed during or after surgery. In all other cases it is done early to confirm the diagnosis and to determine the type of lymphoma
After the initial management all patients have follow-up with hematology.
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