治疗转移性脊柱肿瘤提出了重大挑战，因为目前还没有普遍适用的治疗脊柱转移瘤的指南。本研究旨在为12点硬膜外脊髓压迫分级系统提出一个新的决策框架来治疗转移性脊柱肿瘤患者，并通过多中心分析研究其临床有效性。本研究分析了2017年12月至2017年12月期间的940例转移性脊柱肿瘤患者。 2023年3月。该研究为脊柱转移瘤的全身状况、全身治疗的有效性、神经病学和肿瘤学（SENO）决策框架提供了临床证据。我们的医院于 2021 年 1 月推出 SENO 决策框架，将患者分为 2 组：非 SENO 组 (n = 489) 包括 2017 年 12 月至 2021 年 1 月期间接受治疗的患者，而 SENO 组 (n = 451) 包括2021 年 1 月至 2023 年 3 月接受治疗的患者。 SENO 组患者比非 SENO 组 (P < .001)。此外，SENO 组患者的围手术期并发症较少（9.09% vs 15.34%，P = .004），住院费用较低（P < .001），住院时间较短（P < .001），并且接受了系统治疗更早地治疗肿瘤 (P < .001)。结果，与非 SENO 组患者（279.00 [95% CI：256.91-301.09] 天）相比，SENO 组患者（329.00 [95% CI：292.06-365.94] 天）的生存结果显着改善（P < .001）。出院后 3 个月，与非 SENO 组患者相比，SENO 组患者的生活质量有更大改善，包括身体、社交、情感和功能健康。SENO 决策框架是一个很有前景的方法治疗转移性脊柱肿瘤患者的方法。版权所有 © 神经外科医生大会 2023。保留所有权利。

Treating metastatic spinal tumors poses a significant challenge because there are currently no universally applied guidelines for managing spinal metastases. This study aims to propose a new decision framework for the 12-point epidural spinal cord compression grading system to treat patients with metastatic spinal tumors and investigate its clinical effectiveness in a multicenter analysis.This study analyzed 940 patients with metastatic spinal tumors between December 2017 and March 2023. The study provided the clinical evidence for the systemic conditions, effectiveness of systemic treatment, neurology, and oncology (SENO) decision framework among spine metastases. The SENO decision framework was launched in January 2021 in our hospitals, classifying patients into 2 groups: The non-SENO group (n = 489) consisted of patients treated between December 2017 and January 2021, while the SENO group (n = 451) comprised patients treated from January 2021 to March 2023.Patients in the SENO group were more likely to receive minimally invasive surgery (67.85% vs 58.69%) and less chance of receiving spinal cord circular decompression surgery (14.41% vs 24.74%) than patients in the non-SENO group (P < .001). Furthermore, patients in the SENO group experienced fewer perioperative complications (9.09% vs 15.34%, P = .004), incurred lower hospitalization costs (P < .001), had shorter length of hospitalization (P < .001), and received systematic treatments for tumors earlier (P < .001). As a result, patients in the SENO group (329.00 [95% CI: 292.06-365.94] days) demonstrated significantly improved survival outcomes compared with those in the non-SENO group (279.00 [95% CI: 256.91-301.09], days) (P < .001). At 3 months postdischarge, patients in the SENO group reported greater improvements in their quality of life, encompassing physical, social, emotional, and functional well-being, when compared with patients in the non-SENO group.The SENO decision framework is a promising approach for treating patients with metastatic spinal tumors.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.