To identify patterns in referral and the management pathway of patients with primary bone tumours of the spine referred to the Orthopaedic Spine Unit in order to recommend ways to improve the service. A retrospective notes and imaging review to evaluate the referral pathway undertaken by patients ending up in the orthopaedic spine unit over a 5 year period according to the recommendations for primary bone tumours. Significant events leading to potential improvement in outcomes were assessed. Recommendations for improvements are suggested. None of the 38 patients evaluated were referred within two weeks of presentation, and only 6 were referred directly to the bone tumour service. Almost half (15/32) of the patients who had an indirect referral pathway had a prior intervention. Five of these had non-surgical, while 10 had surgical interventions outside the tumour centre before their referral. Of these, seven had malignant tumours.Aim
Methods and Results
Patients with peripheral primary bone tumours are often identified and referred at an early stage to a regional tumour service according to established guidelines. In patients with primary bone tumours of the spine, however, the definitive management or outcome of such patients is being prejudiced by preliminary intervention from non-specialist services prior to their referral. Objective: To audit the standards of management of patients with primary bone tumours of the spine referred to a regional tumour service. Retrospective review of case notes and radiology. Subjects: Patients with primary bone tumour of the spine managed at the Orthopaedic Spine Unit with the Regional Bone Tumour Service in Newcastle Upon Tyne Hospitals NHS Trust. Referral to tumour service, prior intervention, operative treatment, survival, factors affecting definitive management 31 of 39 (16 benign, 23 malignant) patients were initially referred from primary care to services These tumours present complex issues regarding their definitive management to optimise outcome. Closer links between departments are required to enable the multidisciplinary management of primary bone tumours of the spine. Prior surgical intervention may compromise cure. Those involved in their management should be encouraged to liaise with their regional bone tumour service to improve outcome.
