title: Diagnosis and management of metastatic spine disease.
abstract: Spinal metastases are a significant source of morbidity in patients with systemic cancer. Roughly 30% of patients with cancer develop symptomatic spinal metastases during the course of their illness, and up to 90% of cancer patients possess metastatic lesions within the spine at the time of death with advances in the treatment of systemic disease, survival in such patients has increased. This factor combined with improved imaging modalities will undoubtedly increase the incidence in which spinal metastases are encountered by physicians. In this review, the authors not only attempt to present the myriad ways in which patient with spinal metastases present, but also the means by which they are currently diagnosed and managed. In addition, we propose a simple algorithm to aid in deciding which patients are ideally treated medically and which patients may benefit from surgery.
authors.affiliation: Department of Neurosurgery, School of Medicine, Johns Hopkins University, 600 North Wolfe Street, Meyer 8-161, Baltimore, MD 21287, USA. dsciubb1@jhmi.edu
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sciubba
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D003952:Diagnostic Imaging; D006801:Humans; D019635:Neurosurgical Procedures; D016634:Radiosurgery; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary* / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents