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Abstract Objective To discuss the application value of Rades score in predicting the clinical prognosis of patients with spinal metastasis.Methods From January 2010 to December 2020，127 inpatients，including 83 male and 44 female，aged from 24 to 75 years old with average age (48.8±11.4) years old with spinal metastasis were reviewed from department of orthopedics in the First People’s Hospital of Yibin.We collected the medical records and followed up the clinical outcomes until June 30，2022.The survival curve was drawn by KaplanMeier method.Log-rank Chi-square test and Cox regression analysis were used to analyze the factors affecting the prognosis of patients.Results 127 patients were followed up for 3 to 29 months，with an average of (11.7±4.2) months and a survival time of (10.2±3.7) months，and 97 patients died in the follow-up period with 6-month and 12-month survival rates at 69.29% and-27.56% respectively.The survival time of patients with Rades score of 20~30 points，31~35 points and ≥36 points was (7.12±2.66)，(11.89±2.22) and (17.14±4.91) months，respectively with 6month survival rate of 45.07%，100% and 100% and 1year survival rate at 1.41%，26.09% and 84.85%.The area under the receiver operating characteristic (ROC) curve for predicting the prognosis of patients with Rades score was 0.93 with best cutoff value at 36.5 points.Cox regression showed that the Rades score，the type of primary tumor，whether patients could move freely before treatment，visceral metastasis and the duration from tumor diagnosis to spinal metastasis were the possible influencing factors of the prognosis of spinal metastasis.The harzard ratio (HR) of Rades score of 20~30 and 31~35 points were 41.87 and 4.73 (compared with ≥36 points)，respectively.The HR of lung cancer and other cancers relative to myeloma/lymphoma was 10.04 and 8.48，respectively.The HR of free movement before treatment，without visceral metastasis and tumor diagnosis to spinal metastasis>15 months was 0.70，0.61 and 0.50 respectively (P＜0.05).Conclusion The prognosis of patients with spinal metastasis is poor，and the Rades score is valuable to predict the prognosis of patients，which can guide the rational selection of treatment methods.
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