title: Surgical management of primary and metastatic spinal tumors.
abstract: BACKGROUND
  The axial skeleton is a common site for primary tumors and metastatic disease, with metastatic disease being much more common. Primary and metastatic spinal tumors have a diverse range of aggressiveness, ranging from benign lesions to highly infiltrative malignant tumors.
  
  
  METHODS
  The authors reviewed the results of articles describing the treatment and outcomes of patients with metastatic disease or primary tumors of the spinal column.
  
  
  RESULTS
  En bloc resection is the mainstay of treatment for malignant primary tumors of the spinal column. Intralesional resection is generally appropriate for benign primary tumors. Low-quality evidence supports the use of chemotherapy in select primary tumors; however, radiation therapy is often used for incompletely resected or unresectable lesions. Surgical considerations for the treatment of metastatic disease are more nuanced and require that the health care professional consider patient performance status and the pathology of the primary tumor.
  
  
  CONCLUSIONS
  The treatment of metastatic and primary tumors of the spinal column requires a multidisciplinary approach in order to offer patients the best opportunity for long-term survival.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Kaloostian
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Zadnik
authors.forename: Arnold B
authors.initials: AB
authors.lastname: Etame
authors.forename: Frank D
authors.initials: FD
authors.lastname: Vrionis
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sciubba
mesh_terms: D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome