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Review
. 2020 Jan 31;54(2):181-193.
doi: 10.1007/s43465-019-00008-2. eCollection 2020 Apr.

Principles of Management of Spine Metastasis

Vineet Kurisunkal  1 , Ashish Gulia  1 , Srinath Gupta  1
Affiliations
Review

Principles of Management of Spine Metastasis

Vineet Kurisunkal et al. Indian J Orthop. .

Abstract

Background: With evolution of medicine, radiation therapy and surgical methods, cancer care has improved the quality of life for patients with improved survival and functional status in patients with skeletal metastasis. The most common site of skeletal metastases from other primary malignant neoplasms is the spine, hence, understanding the epidemiology of metastatic spine disease and its presentation is essential for developing a diagnostic and treatment strategy which eventually results in optimum care to reduce disease-related morbidity.

Purpose: With this review article we intend to describe an evidence-based review on the presentation, diagnosis and treatment of metastatic spinal disease.

Methods: We reviewed the current available literature on management of spinal metastasis and have described a step wise evaluation and management strategy of metastatic spine disease.

Conclusion: The present review article addresses various aspects and related controversies related to evaluation, staging and treatment options in the management of spinal metastasis.

Keywords: Back pain; Radiotherapy; SRS; Spine metastasis.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Metastatic carcinoma of breast. a, b Magnetic resonance imaging sections showing cord compression. Managed with palliative radiotherapy and vertebroplasty (c, d). e, f Two years follow-up as noted on magnetic resonance imaging (e) and plain radiographs (f)
Fig. 2
Fig. 2
Metastatic carcinoma of papillary thyroid with spine metastasis at L4 vertebra. a FDG-PET showing solitary site of metastases. b, c Magnetic resonance imaging B (axial), c (sagittal) sections showing cord compression. d, e Follow-up images post radioactive iodine (RAI), angioembolization and radiotherapy
Fig. 3
Fig. 3
Metastatic carcinoma of lung. a, b Magnetic resonance imaging showing sagittal and coronal sections with cord compression due to soft tissue component. Treated with radiotherapy
Fig. 4
Fig. 4
Metastatic carcinoma of prostrate. a, b Sagittal sections showing multilevel disease in vertebrae. c Axial image showing cord compression at D9 vertebrae. d Intra-operative image post spinal decompression and posterior stabilization. e Post operative radiograph
See this image and copyright information in PMC

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