J Korean Ster Func Neurosurg.  2021 Sep;17(2):70-77. 10.52662/jksfn.2021.00087.

An updated algorithm for the treatment of spinal metastasis

• Park K
• Son S
• Lee SG
• Cho EK
• Ahn HK
• Park IK
• Sym SJ
• Kim YS

• KMID: 2534575
• DOI: http://doi.org/10.52662/jksfn.2021.00087

Abstract

Treatment for spinal metastasis aims to improve patients’ quality of life through specific goals that include improving neurological function, local tumor control, mechanical stabilization, and pain relief. However, various previous strategies have limitations in terms of the application of recent developments in stereotactic radiosurgery (SRS) and minimally invasive spine surgery (MISS), the safety and efficacy of which for spinal metastasis have been well established during the past decade. In this article, we review several previous strategies for the treatment of spinal metastasis and present a new treatment algorithm. This algorithm includes the use of single-fraction SRS and MISS for spinal metastasis. SRS currently offers safe and effective local tumor control in a way that is convenient for patients. Furthermore, MISS (including vertebroplasty, percutaneous pedicle screw fixation, and mini-open decompression) leads to considerable improvements in pain and neurological symptoms with a lower complication rate than conventional open surgery. Based on this new algorithm, patients with spinal metastasis can achieve a better quality of life through fast pain relief, rapid recovery, and minimal discontinuation of chemotherapy. This novel algorithm will enhance patient-centered care in spinal metastasis and can ultimately serve as a simple guideline for spinal metastasis treatment.

Keyword

Spinal metastasis; Radiosurgery; Strategy; Minimally invasive spine surgery