Malignant Spinal Osseous Lesions and Vertebral Augmentation

The management of metastatic disease to the spine is often complex and requires an integrated approach with input from an interdisciplinary cancer team. Vertebroplasty and kyphoplasty are considered very effective procedures for achieving pain control and preventing further vertebral body collapse resulting in kyphotic deformities and thecal sac compression. In this chapter, we discuss the pathogenesis of osseous metastases, pathophysiology of pain related to secondary spinal neoplasms, and clinically relevant features of spinal metastases secondary to different primary tumors. The most important imaging characteristics of the metastatic disease to the spine are discussed. Also, we outline the general concept of percutaneous vertebral augmentation for malignant spinal lesions.