ABSTRACT
Metastatic spine tumor surgery is most often a palliative measure. Because few cases can be cured, the goals of intervention center on neurologic function maintenance, mechanical stabilization, and pain alleviation. Nonsurgical management strategies include radiation therapy, pharmacotherapy, and minimally invasive procedures. Radiation treatment can address each of the goals of therapy. Surgery is the best option to obtain optimal resection, decompression, and stabilization. Factors considered for surgical candidacy include functional status, age, life expectancy, systemic disease extent, and tumor resistance to adjuvant treatment. There are several major systems of metastatic spine tumor classification; the Tomita and revised Tokuhashi schemes are considered the most functional for practical application. Treatment options include surgery, radiotherapy, and chemotherapy. Adjuvant chemotherapy and radiotherapy can help prevent local recurrence. In primary tumor types that are refractory to conventional radiation treatment, osteosarcomas and chondrosarcomas, particle beam treatment may hold promise.
