Updates in the Management of Metastatic Spine Disease.
Instr Course Lect
; 73: 665-673, 2024.
Article
em En
| MEDLINE
| ID: mdl-38090932
ABSTRACT
The number of cancer diagnoses continues to increase each year in the United States, and given the propensity for bone metastases from solid organ malignancies, orthopaedic spine surgeons will inevitably encounter patients with metastatic spine disease and need to have a framework for approaching the evaluation and treatment of these complex patients. Many patients seeking care for spinal metastases already have a history of disseminated malignancy, but metastatic spine disease itself will be the presenting symptom of cancer in approximately 20% of patients. Because the first presentation of cancer may be to a spine surgeon, an appropriate strategy for the initial evaluation of a patient with a new spinal lesion is critical to establish the diagnosis of metastatic disease before undergoing treatment. Once the diagnosis of metastatic spine disease is confirmed, decisions regarding treatment should be made in coordination with a multidisciplinary team including radiation oncology and medical oncology. Spinal metastases are most often treated with radiation therapy. Direct circumferential decompression of the spinal cord with postoperative radiation therapy is considered for high-grade epidural spinal cord compression to preserve neurologic function. Mechanical spinal instability is another potential indication for surgery. When considering surgery, the patient's medical fitness, systemic burden of cancer, and overall prognosis all must be accounted for, and the importance of multidisciplinary evaluation and shared decision making cannot be overstated.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Compressão da Medula Espinal
/
Neoplasias da Coluna Vertebral
Limite:
Humans
Idioma:
En
Revista:
Instr Course Lect
Ano de publicação:
2024
Tipo de documento:
Article