timing of surgery, but longer-term outcomes has received comparatively little attention. PURPOSE: A detailed assessment of long-term outcomes after decompres- sive surgery for CES in 23 patients. STUDY DESIGN/SETTING: Retrospective cohort study with prospec- tive long-term follow-up. PATIENT SAMPLE: 23 patients with CES due to disc protrusion between 2004–2014. OUTCOME MEASURES: Post-operative bladder, bowel and sexual function. METHODS: Retrospective cohort study of CES patients. Used validated IPSS & ICIQ-UI urological, bowel and sexual function patient questionnaires. RESULTS: 23 of 29 patients (10M, 13F, mean age 50 yrs) with CES re- sponded with a mean time to follow up of 7 years. Eight presented as complete CES versus 15 with incomplete. Mean time-to-surgery from onset of symp- toms was 21 hours. Fourteen reported ongoing urinary problems of which 9 still use a urinary catheter. Mean voiding dysfunction (IPSS) and incon- tinence (ICIQ-SF) scores were 10 (range 0–26) and 9 (range 2–19) respectively, indicating moderate severity. Four of the 10 male and 12 of the 13 females report sexual dysfunction. 12 of 23 also report bowel dysfunction includ- ing 3 with faecal incontinent. 17 of 23 have a Karnofsky performance score of 80% or more. CONCLUSIONS: Our study suggests long-term sphincteral and sexual mor- bidity is associated with CES. The 4 patients who fully recovered at 6–18 months had a shorter mean time-to-surgery of 11 hours. This study also high- lights the importance of managing patients’ expectations with further treatment and support. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2016.12.049 42. Spinal injuries in rugby union—a comparison with cycling over 15 years Niall Eames, L. Murphy, S. McDonald, M. Webb, C. Bleakley, R. Nicholas, P. Archibold; Royal Victoria Hospital Belfast BACKGROUND CONTEXT: Concerns have been expressed regarding the safety of rugby. It remains a popular sport. Cycling continues to increase in popularity and is expounded as a good form of exercise. PURPOSE: To evaluate incidence of serious spinal injuries in rugby over a 15 year period and compare to cycling injuries. STUDY DESIGN/SETTING: Retrospective review of prospectively col- lected clinical data. PATIENT SAMPLE: Rugby and cycling injuries admitted to Northern Ireland regional spinal unit 2000 to 2015. OUTCOME MEASURES: Spinal injuries requiring hospital admission. METHODS: Prospective data for all admissions interrogated. (RISUS and FORD data bases). RESULTS: 158 injuries identified. Twice as many patients admitted with serious spinal injuries from cycling cf rugby (103 vs. 55). 89% males. Mean age younger in rugby 21.8 yrs cf cycling 38 yrs. 98% of injuries in rugby were to the cer- vical spine cf 55% in cycling. 10 rugby players (18%) required surgery cf 32 cyclists (31%). 2 (4%) rugby players required prolonged ICU admission cf 9 (9%) of cyclists. 3 complete paralysis occurred in rugby players over the 15 years cf 5 cyclists. The incidence of rugby associated injuries has remained static, whereas cycling injuries have more than trebled in 2015 cf 2000. CONCLUSIONS: Cycling injuries are twice as common as rugby injuries. Cervical injuries account for a higher proportion of those injured in rugby players, but total numbers of patients requiring surgery and ICU admission were 2 to 3 times higher for cycling injuries. Rugby is not a significant cause of spinal injuries nor is it increasing cf cycling injuries which continue to rise. CONFLICTS OF INTEREST: None. FUNDING SOURCES: MITRE Trust, Irish Rugby Football Union. http://dx.doi.org/10.1016/j.spinee.2016.12.050 Spinal Tumour 43. Evaluation of prognostic factors and a modification to the modified tokuhashi score in patients with spinal metastases from breast cancer Jonathan Tan, KimberlyAnne Tan, Aye Sandar Zaw, Dennis Hey, Aravind Kumar, Naresh Kumar; University Spine Centre, National University Hospital of Singapore, 1E Kent Ridge Rd, NUHS Tower Block, Level 11, Singapore 119228 BACKGROUND CONTEXT: The modified Tokuhashi score does not take into account receptor subtypes, Estrogen receptor (ER), progesterone re- ceptor (PgR), and human epidermal growth factor receptor 2 (Her-2) in prognosticating breast cancer. PURPOSE: To evaluate the prognostic value of receptor subtypes in Breast cancer patients with spinal metastases and the accuracy of a modification of the modified Tokuhashi score. STUDY DESIGN/SETTING: Retrospective cohort study. PATIENT SAMPLE: 185 breast cancer patients treated for spinal metas- tases between May 2001 and April 2012. OUTCOME MEASURES: Survival from the time of diagnosis. METHODS: Prognostic factors investigated using univariate and multi- variate analyses. Patients were scored according to the modified Tokuhashi score (A) and a modification where patients who were Hormone receptor negative (ER and PgR negative) and triple negative (ER, PgR and Her-2 neg- ative) had histological score reduced from 5 to 3 (Tokuhashi B). Predictive values of each scoring system for 6- and 12-month survival were measured via receiver operating characteristic (ROC) curves. RESULTS: Multivariate analysis revealed that ER receptor status (p=.004) and Her-2 receptor status (p=.01) were significant predictors of survival. Tokuhashi A had an AUROC (area under receiver operating curve) of 0.57 and 0.62 while Tokuhashi B had an AUROC of 0.62 and 0.70, at 6 and 12 months respectively, this was statistically significant (p=.046). CONCLUSIONS: The effect of histological subtype and the effect of newer targeted molecular therapy should be taken into account and surgical man- agement should not be based on the results of prognostic scoring systems. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2016.12.051 44. Is balloon kyphoplasty safe and effective for cancer-related vertebral compression fractures with posterior vertebral body wall defects? Asif Alrawi 1 , Kathak Vachhani 1,2 , Rachel Maguire 1,2 , Mathew David Sewell 1 , Waleed Hekal 1 , Susanne Selvadurai 2 , Rikin Hargunani 2 , Charalampia Kyriakou 1,2 , Sean Molloy 2 ; 1 The James Cook University Hospital, Middlesbrough, UK; 2 The Royal National Orthopaedic Hospital, Stanmore BACKGROUND CONTEXT: Balloon kyphoplasty (BKP) is a percuta- neous treatment for cancer-related vertebral compression fractures (VCF). Posterior vertebral body wall (PVBW) involvement is considered a contra- indication for BKP. PURPOSE: This study assesses whether BKP is safe and effective for cancer- related VCFs involving the PVBW. STUDY DESIGN/SETTING: Multi-centre cohort study using prospec- tively collected data from a metastatic tumour database. PATIENT SAMPLE: 160 patients with 230 cancer-related VCFs who un- derwent BKP. OUTCOME MEASURES: 1. Primary outcomes were visual analogue pain scores and patient related outcome measures: Oswestry Disability Index (ODI) and the EQ5D quality of life (QoL) index. 2. Secondary outcomes were radiographic parameters and complication rates. S16 BASS 2017 abstracts / The Spine Journal 17 (2017) S3–S22 Refer to onsite annual meeting presentations and postmeeting proceedings for possible referenced figures and tables.Authors are responsible for accurately reporting disclosure and FDA device/drug status at time of abstract submission.