ABSTRACT
Skeleton is the third most common site of metastasis, and up to 70% of all cancer patients may develop spine metastases during the natural course of their disease. Spine metastases most frequently present with back pain. Radiosurgery was first described by Lars Leksell in 1951 for the treatment of intracranial lesions, and since then intracranial radiosurgery has become a cornerstone for the treatment of both benign and malignant intracranial diseases. Spine SRS is typically performed in a single or limited number of fractions. Indications tend to be institution-specific; however, patients with a long predicted life expectancy, good Karnofsky Performance Score, radioresistant histology, limited spine metastases, oligometastases, and well-controlled systemic disease are generally considered good candidates for spine SRS. Spine SRS is a resource-intensive treatment modality requiring extensive experience and expertise as well as multidisciplinary involvement of radiation oncologists, neurosurgeons, medical physicists, and radiation therapists.
