Surgical Management of Spinal Metastases

Paul Klimo, Meic H. Schmidt

Research output: Contribution to journalReview article

201 Citations (Scopus)

Abstract

Metastatic spread to the spinal column is a growing problem in patients with cancer. It can cause a number of sequelae including pain, instability, and neurologic deficit. If left untreated, progressive myelopathy results in the loss of motor, sensory, and autonomic functions. Except in rare circumstances, treatment is palliative. Traditionally, conventional fractionated external beam radiotherapy has been the treatment of choice. "Surgery" for metastatic spinal disease was, and generally continues to be, equated with laminectomy by many physicians. However, there has been a remarkable evolution in surgical techniques over the last 20 years. Today, the goal of surgery is to achieve circumferential decompression of the neural elements while reconstructing and immediately stabilizing the spinal column. This has been made possible by the use of different surgical approaches and the exploitation of a burgeoning array of internal fixation devices. More recently, minimally invasive surgical techniques, such as endoscopy, kyphoplasty/vertebroplasty, and stereotactic radiosurgery, have been added to the surgeon's armamentarium. As the number of treatment options for metastatic spinal disease grows, it has become clear that effective implementation of treatment can only be achieved by a multidisciplinary approach. This will provide the surest means of maximizing the quality of the remainder of the patient's life.

Original languageEnglish (US)
Pages (from-to)188-196
Number of pages9
JournalOncologist
Volume9
Issue number2
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

Fingerprint

Spinal Diseases
Neoplasm Metastasis
Spine
Internal Fixators
Kyphoplasty
Vertebroplasty
Laminectomy
Radiosurgery
Spinal Cord Diseases
Neurologic Manifestations
Decompression
Palliative Care
Endoscopy
Radiotherapy
Therapeutics
Physicians
Pain
Neoplasms
Surgeons

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Surgical Management of Spinal Metastases. / Klimo, Paul; Schmidt, Meic H.

In: Oncologist, Vol. 9, No. 2, 01.01.2004, p. 188-196.

Research output: Contribution to journalReview article

Klimo, Paul ; Schmidt, Meic H. / Surgical Management of Spinal Metastases. In: Oncologist. 2004 ; Vol. 9, No. 2. pp. 188-196.
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