An update in the management of spinal metastases

Arquivos de Neuro-Psiquiatria

Andrei F. Joaquim¹  Ann Powers¹  Ilya Laufer¹  Mark H. Bilsky¹ 

关键词: spinal metastases;    bone metastases;    diagnosis;    management;    treatment;    NOMS;    metastases de coluna;    metástases ósseas;    diagnóstico;    manejo;    tratamento;    NOMS;   

DOI  :  10.1590/0004-282X20150099

来源: SciELO

【 摘 要 】

The best clinical treatment for spinal metastases requires an integrated approach with input from an interdisciplinary cancer team. The principle goals of treatment are maintenance or improvement in neurologic function and ambulation, spinal stability, durable tumor control, and pain relief. The past decade has witnessed an explosion of new technologies that have impacted our ability to reach these goals, such as separation surgery and minimally invasive spinal procedures. The biggest advance, however, has been the evolution of stereotactic radiosurgery that has demonstrated durable tumor control both when delivered as definitive therapy and as a postoperative adjuvant even for tumors considered markedly resistant to conventional external beam radiation. In this paper, we perform an update on the management of spinal metastases demonstrating the integration of these new technologies into a decision framework NOMS that assesses four basic aspects of a patient’s spine disease: Neurologic, Oncologic, Mechanical Instability and Systemic disease.

【 授权许可】

CC BY   
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