An update in the management of spinal metastases.

Abstract:

:The best clinical treatment for spinal metastases requires an integrated approach with input from an interdisciplinary cancer team. The principle goals of treatment are maintenance or improvement in neurologic function and ambulation, spinal stability, durable tumor control, and pain relief. The past decade has witnessed an explosion of new technologies that have impacted our ability to reach these goals, such as separation surgery and minimally invasive spinal procedures. The biggest advance, however, has been the evolution of stereotactic radiosurgery that has demonstrated durable tumor control both when delivered as definitive therapy and as a postoperative adjuvant even for tumors considered markedly resistant to conventional external beam radiation. In this paper, we perform an update on the management of spinal metastases demonstrating the integration of these new technologies into a decision framework NOMS that assesses four basic aspects of a patient's spine disease: Neurologic, Oncologic, Mechanical Instability and Systemic disease.

journal_name

Arq Neuropsiquiatr

authors

Joaquim AF,Powers A,Laufer I,Bilsky MH

doi

10.1590/0004-282X20150099

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

795-802

issue

9

eissn

0004-282X

issn

1678-4227

pii

S0004-282X2015000900795

journal_volume

73

pub_type

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