Weinstein Boriani Biagini classification

The shortcomings of the classification systems of McLain and Weinstein 1) and Enneking 2) , were partly addressed by Boriani et al. who developed a new staging system for primary vertebral tumor 3).

Enneking classification in treatment of spine tumors has been found to be insufficient for surgical planning over time. Because of that, in 1997, Boriani et al have published a study about the new terminology and surgical staging for primary spine tumors. The authors stated a new classification system known as Weinstein Boriani Biagini classification, which is still actively in use today 4).

https://openi.nlm.nih.gov/detailedresult.php?img=PMC4472586_asj-9-386-g001&req=4

The WBB surgical staging system describes the involvement of a specific vertebra in terms of sectors involved, arranged clockwise in 12 sectors on an axial vertebral face. The lesion is further confined to five layers of tissue penetration denoted as A-E

A— Extra-osseous soft tissue

B — Intrauosseous superficial

C — Intraosseous deep

D — Extraosseous (extradural)

E — Extraosseous (intradural)

Results indicate moderate interobserver reliability and substantial and near-perfect intraobserver reliability for both the Enneking and WBB classification in terms of staging and guidance for treatment, despite a less than moderate interobserver reliability in interpreting the Enneking local tumor extension and WBB sector. Before incorporating the classifications in the clinical practice and research studies, further work is required to investigate the validity of the classifications 5).

http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1681-150X2011000300003

1)
McLain RF, Weinstein JN. Tumors of the spine. Semin Spine Surg. 1990;2:157–180.
2)
Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res. 1980 Nov-Dec;(153):106-20. PubMed PMID: 7449206.
3) , 4)
Boriani S, Weinstein JN, Biagini R. Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976). 1997 May 1;22(9):1036-44. Review. PubMed PMID: 9152458.
5)
Chan P, Boriani S, Fourney DR, Biagini R, Dekutoski MB, Fehlings MG, Ryken TC, Gokaslan ZL, Vrionis FD, Harrop JS, Schmidt MH, Vialle LR, Gerszten PC, Rhines LD, Ondra SL, Pratt SR, Fisher CG. An assessment of the reliability of the Enneking and Weinstein-Boriani-Biagini classifications for staging of primary spinal tumors by the Spine Oncology Study Group. Spine (Phila Pa 1976). 2009 Feb 15;34(4):384-91. doi: 10.1097/BRS.0b013e3181971283. PubMed PMID: 19214098.