title: Management of metastatic spine disease.
abstract: OBJECTIVE
  In metastatic spine disease, technologic advancements, neurologic recovery, pain relief, cost-effectiveness, and health-related quality of life have all strengthened surgery's and radiation's role in its management.We evaluated different surgical approaches to the spine and the multimodality treatment in the management of these cases.
  
  
  RESULTS
  Recently, the survival rate of malignant spinal metastases has rapidly improved because of early detection and multimodality treatment. The goals of surgical intervention are to prolong survival and improve the quality of life of patients.The recent evolution of imaging, radiosurgery, advanced surgical decompressive techniques and instrumentation, as well as percutaneous vertebral body cement augmentation, needs to be considered in the decision-making to optimize patient outcomes.
  
  
  CONCLUSIONS
  Management of patients with spine tumors requires a multidisciplinary team that includes a medical and radiation oncologist and a spine surgeon. Newer surgical techniques that address both tumor resection and spinal stabilization offer the best outcome in selected patients. The prognostic parameters suggested for metastatic spine tumors include the general condition of the patient, neurological status number of spinal and extraspinal metastases, primary site of the cancer, visceral metastasis, and severity of spinal cord compression.
authors.affiliation: H. Lee Moffitt Cancer Center & Research Institute, NeuroOncology Program and Department of Neurosurgery, University of South Florida College of Medicine, Tampa, Florida 33612, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Eleraky
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papanastassiou
authors.forename: Frank D
authors.initials: FD
authors.lastname: Vrionis
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D009362:Neoplasm Metastasis / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy*; D011788:Quality of Life / Q000523:psychology*; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods; D013117:Spinal Cord Compression / Q000209:etiology; D013125:Spinal Neoplasms / Q000188:drug therapy* / Q000523:psychology / Q000556:secondary / Q000601:surgery; D013131:Spine / Q000601:surgery*; D014481:United States
chemical_list: D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates