How are metastatic spinal tumors treated?

Updated: Nov 01, 2018
  • Author: Andrew A Sama, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

Various prognostic scoring systems have been developed to assess candidacy for surgery in patients with vertebral metastases, including the  Tokuhashi, Tomita, Bauer, Oswestry, Van der Linden, Rades, and Katagiri systems. The Spinal Instability Neoplastic Score (SINS) differs from others in that it looks for impending spinal instability. A review by Cassidy et al found that the Bauer and Oswestry systems predicted the prognosis most accurately and noted that the SINS showed good reliability for predicting instability among surgeons and oncologists. [30]

Stereotactic body radiotherapy (SBRT) is a newer approach to treating spinal metastases that has been described as having potential advantages over external beam radiotherapy. [31, 32, 33, 34]  

Advances in the molecular understanding of metastatic spinal tumors are likely to bring about substantial changes in management paradigms. [35, 36]  Through molecular characterization, critical information can be obtained that can be used for making the initial diagnosis, determining the optimal treatment approach, evaluating the efficacy of treatment, and monitoring for recurrence, as well as for predicting complications, clinical outcome, and overall survival.


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