4.5 Review

Radiotherapy and Surgical Advances in the Treatment of Metastatic Spine Tumors: A Narrative Review

Journal

WORLD NEUROSURGERY
Volume 151, Issue -, Pages 147-154

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2021.05.032

Keywords

Cryoablation; CyberKnife; LITT; Minimally invasive surgery; Radiation therapy; Spine tumor

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Treatment of spine tumors varies greatly, with options ranging from surgery to nonsurgical interventions, including invasive and minimally invasive procedures. Advances in technology have provided modern spinal oncologists with a wider range of treatment options.
Spine tumors encompass a wide range of diseases with a commensurately broad spectrum of available treatments, ranging from radiation for spinal metastases to highly invasive en bloc resection for primary vertebral column malignancies. This high variability in treatment approaches stems both from variability in the goals of surgery (e.g., oncologic cure vs. symptom palliation) and from the significant advancements in surgical technologies that have been made over the past 2 decades. Among these advancements are improvements in surgical technique, namely minimally invasive approaches, increased availability of focused radiation modalities (e.g., proton therapy and linear accelerator devices), and new surgical technologies, such as carbon fiber-reinforced polyether ether ketone rods. In addition, several groups have described nonsurgical interventions, such as vertebroplasty and kyphoplasty for spinal instability secondary to pathologic fracture, and lesion ablation with spinal laser interstitial thermoablation, radiofrequency ablation, or cryoablation. We provide an overview of the latest technological advancements in spinal oncology and their potential usefulness for modern spinal oncologists.

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