Chapter - Follow-up and functional scores: PROMs.

Spinal metastases represent a major event in the course of cancer, frequently resulting in pain, neurological impairment, reduced functional capacity, and diminished quality of life. Traditional assessment of these patients has largely relied on clinical examination, radiological findings, and prognostic scoring systems. However, these approaches may not fully capture the patient's experience of disease and treatment. Patient-reported outcome measures (PROMs) provide a standardised method for evaluating symptoms, functional status, and health-related quality of life from the patient's perspective. This chapter reviews the principal PROMs currently used in patients with spinal metastases, including generic instruments such as the Short Form-36 (SF-36), EuroQol-5 Dimension (EQ-5D), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and the Brief Pain Inventory (BPI), as well as spine-specific tools including the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ) and the MD Anderson Symptom Inventory-Spine Tumor Module (MDASI-Spine) Particular attention is given to the Patient-Reported Outcomes Measurement Information System (PROMIS), an emerging instrument that combines strong psychometric performance with reduced respondent burden through computer adaptive testing. Current evidence suggests that PROMIS demonstrates validity and responsiveness comparable to established instruments while offering improved efficiency in clinical practice. PROMs are increasingly recognised as essential components of patient-centred care in spinal oncology. Their systematic integration into clinical research and routine practice may improve outcome assessment, support therapeutic decision-making, and ultimately enhance quality of life for patients with spinal metastases.