title: Spine Oncology-Metastatic Spine Tumors.
abstract: Surgery for spinal metastases remains the mainstay treatment for pain, instability, and neurological deterioration due to tumor infiltration of the spine. However, several new therapies are emerging which may improve outcomes further, and in some cases even replace the need for surgery. We now have a better understanding of which factors influence survival and quality of life after surgery, and this underpins the development and application of new treatments, and assessment of outcome.Depending on genetic subtyping of tumors, novel immunotherapies and chemotherapies may be very effective in prolonging quality of life. New surgical techniques allow smaller, quicker, and safer operations with less blood loss, pain, and quicker recovery after surgery. Radiation treatments have also leapt forward with the greater accuracy and higher doses possible from intensity-modulated photon radiation, stereotactic body radiation treatment, proton beam therapy, or carbon ion treatment. Combined with more advanced materials for vertebral body stabilization, computer navigation systems, and robotics, more can be done at earlier or later stages of the spinal disease than was previously possible, resulting in more options and improved outcomes for patients.
authors.affiliation: Department of Neurosurgery, the Natio-nal Hospital for Neurology and Neuros-urgery, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Bilsky
authors.affiliation: Division of Neurosurgery and Spinal Program, University of Toronto, Toronto, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Fehlings
authors.affiliation: Department of Orthopaedics, Division of Spine, University of British Columbia and Vancouver General Hospital, Vancouver, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Fisher
authors.affiliation: Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Ziya
authors.initials: Z
authors.lastname: Gokaslan
mesh_terms: D006801:Humans; D019635:Neurosurgical Procedures; D019637:Orthopedic Procedures; D011788:Quality of Life; D016634:Radiosurgery; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*
keywords: Metastasis; Spine; Surgery; Tumor