TY - JOUR
T1 - Primary Bone Tumor of the Spine—An Evolving Field
T2 - What a General Spine Surgeon Should Know
AU - Charest-Morin, Raphaële
AU - Fisher, Charles G.
AU - Sahgal, Arjun
AU - Boriani, Stefano
AU - Gokaslan, Ziya L.
AU - Lazary, Aron
AU - Reynolds, Jeremy
AU - Bettegowda, Chetan
AU - Rhines, Laurence D.
AU - Dea, Nicolas
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.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Study Design: A narrative review of the literature. Objective: This article reviews the general principles of treatment and investigation for primary bone tumors of the spine. Furthermore, it explores the emerging alternatives. Methods: A review was performed using Medline, Embase, and Cochrane databases. Results: Primary bone tumors of the spine are rare entities that general spine surgeons may encounter only a few times in their career. The treatment algorithm of these complex tumors is filled with nuances and is evolving constantly. For these reasons, patients should be referred to experienced tertiary or quaternary centers who can offer a comprehensive multidisciplinary approach. For most malignant spinal bone tumors, surgery remains the cornerstone of treatment. Respecting oncologic principles has been associated with improved survival and decreased local recurrence in multiple settings. However, even in experienced centers, these surgeries carry a significant risk of adverse events and possible long-term neurologic impairment. The associated morbidity of these procedures and the challenges of local recurrence have encouraged professionals caring for these patients to explore alternatives or adjuncts to surgical treatment. Conclusions: Over the past few years, several advances have occurred in medical oncology, radiation oncology and interventional radiology, changing the treatment paradigm for some tumors. Other advances still need to be refined before being applied in a clinical setting.
AB - Study Design: A narrative review of the literature. Objective: This article reviews the general principles of treatment and investigation for primary bone tumors of the spine. Furthermore, it explores the emerging alternatives. Methods: A review was performed using Medline, Embase, and Cochrane databases. Results: Primary bone tumors of the spine are rare entities that general spine surgeons may encounter only a few times in their career. The treatment algorithm of these complex tumors is filled with nuances and is evolving constantly. For these reasons, patients should be referred to experienced tertiary or quaternary centers who can offer a comprehensive multidisciplinary approach. For most malignant spinal bone tumors, surgery remains the cornerstone of treatment. Respecting oncologic principles has been associated with improved survival and decreased local recurrence in multiple settings. However, even in experienced centers, these surgeries carry a significant risk of adverse events and possible long-term neurologic impairment. The associated morbidity of these procedures and the challenges of local recurrence have encouraged professionals caring for these patients to explore alternatives or adjuncts to surgical treatment. Conclusions: Over the past few years, several advances have occurred in medical oncology, radiation oncology and interventional radiology, changing the treatment paradigm for some tumors. Other advances still need to be refined before being applied in a clinical setting.
KW - en bloc resection
KW - interventional radiology
KW - medical treatment
KW - molecular sequencing
KW - primary spine tumors
KW - radiation oncology
KW - surgery
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U2 - 10.1177/2192568219828727
DO - 10.1177/2192568219828727
M3 - Review article
C2 - 31157142
AN - SCOPUS:85065783044
SN - 2192-5682
VL - 9
SP - 108S-116S
JO - Global Spine Journal
JF - Global Spine Journal
IS - 1_suppl
ER -