TY - JOUR
T1 - Essential Concepts for the Management of Metastatic Spine Disease
T2 - What the Surgeon Should Know and Practice
AU - on behalf of the AOSpine Knowledge Forum Tumor
AU - Barzilai, Ori
AU - Boriani, Stefano
AU - Fisher, Charles G.
AU - Sahgal, Arjun
AU - Verlaan, Jorrit Jan
AU - Gokaslan, Ziya L.
AU - Lazary, Aron
AU - Bettegowda, Chetan
AU - Rhines, Laurence D.
AU - Laufer, Ilya
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was organized and funded by AOSpine International through the AOSpine Knowledge Forum Tumor, a focused group of international spine oncology experts acting on behalf of AOSpine. Study support was provided directly through the AOSpine Research Department.
Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Boriani reports educational commitments with K2M and Nuvasive, which are outside the submitted work. Dr Fisher reports consulting and royalties from Medtronic; research grants from OREF; and fellowship support paid to institution from AOSpine and Medtro-nic, which are all outside the submitted work. Dr Sahgal reports past educational seminars with Elekta AB, Accuray Inc, and Varian medical systems; research grant with Elekta AB; travel accommodations and expenses from Elekta and Varian; and belongs to the Elekta MR Linac Research Consortium. Dr Gokaslan reports research support from AOSpine North America and stock ownership of Spinal Kinetics, which are all outside the submitted work. Dr Rhines reports educational commitments with Stryker, which are outside the submitted work. Dr Laufer reports receiving consulting fees from Globus, Depuy/Synthes, and SpineWave.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Study Design: Literature review. Objective: To provide an overview of the recent advances in spinal oncology, emphasizing the key role of the surgeon in the treatment of patients with spinal metastatic tumors. Methods: Literature review. Results: Therapeutic advances led to longer survival times among cancer patients, placing significant emphasis on durable local control, optimization of quality of life, and daily function for patients with spinal metastatic tumors. Recent integration of modern diagnostic tools, precision oncologic treatment, and widespread use of new technologies has transformed the treatment of spinal metastases. Currently, multidisciplinary spinal oncology teams include spinal surgeons, radiation and medical oncologists, pain and rehabilitation specialists, and interventional radiologists. Consistent use of common language facilitates communication, definition of treatment indications and outcomes, alongside comparative clinical research. The main parameters used to characterize patients with spinal metastases include functional status and health-related quality of life, the spinal instability neoplastic score, the epidural spinal cord compression scale, tumor histology, and genomic profile. Conclusions: Stereotactic body radiotherapy revolutionized spinal oncology through delivery of durable local tumor control regardless of tumor histology. Currently, the major surgical indications include mechanical instability and high-grade spinal cord compression, when applicable, with surgery providing notable improvement in the quality of life and functional status for appropriately selected patients. Surgical trends include less invasive surgery with emphasis on durable local control and spinal stabilization.
AB - Study Design: Literature review. Objective: To provide an overview of the recent advances in spinal oncology, emphasizing the key role of the surgeon in the treatment of patients with spinal metastatic tumors. Methods: Literature review. Results: Therapeutic advances led to longer survival times among cancer patients, placing significant emphasis on durable local control, optimization of quality of life, and daily function for patients with spinal metastatic tumors. Recent integration of modern diagnostic tools, precision oncologic treatment, and widespread use of new technologies has transformed the treatment of spinal metastases. Currently, multidisciplinary spinal oncology teams include spinal surgeons, radiation and medical oncologists, pain and rehabilitation specialists, and interventional radiologists. Consistent use of common language facilitates communication, definition of treatment indications and outcomes, alongside comparative clinical research. The main parameters used to characterize patients with spinal metastases include functional status and health-related quality of life, the spinal instability neoplastic score, the epidural spinal cord compression scale, tumor histology, and genomic profile. Conclusions: Stereotactic body radiotherapy revolutionized spinal oncology through delivery of durable local tumor control regardless of tumor histology. Currently, the major surgical indications include mechanical instability and high-grade spinal cord compression, when applicable, with surgery providing notable improvement in the quality of life and functional status for appropriately selected patients. Surgical trends include less invasive surgery with emphasis on durable local control and spinal stabilization.
KW - metastases
KW - oncology
KW - stereotactic body therapy (SBRT)
KW - surgery
KW - tumors
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U2 - 10.1177/2192568219830323
DO - 10.1177/2192568219830323
M3 - Article
C2 - 31157152
AN - SCOPUS:85065791427
SN - 2192-5682
VL - 9
SP - 98S-107S
JO - Global Spine Journal
JF - Global Spine Journal
IS - 1_suppl
ER -