Estimating survival and choosing treatment for spinal metastases: Do spine surgeons agree with each other?

Purpose: This study aimed to investigate spine surgeons’ ability to estimate survival in patients with spinal metastases and whether survival estimates influence treatment recommendations. Methods: 60 Spine surgeons were asked a survival estimate and treatment recommendation in 12 cases. Intraclass correlation coefficients and descriptive statistics were used to evaluate variability, accuracy and association of survival estimates with treatment recommendation. Results: There was substantial variability in survival estimates amongst the spine surgeons. Survival was generally overestimated, and longer estimated survival seemed to lead to more invasive procedures. Conclusions: Prognostic models to estimate survival may aid surgeons treating patients with spinal metastases.