| Abstract: |
The overall oncologic management of patients with metastatic disease is fraught with many challenges. With patients living longer due to advances in care, optimal surgical and radiation options for treating spinal metastases are paramount to preserving quality of life in these individuals. A multidisciplinary approach to managing these patients involving interventional radiologists, radiation oncologists, and plastic surgeons, among others, has demonstrated enormous benefits in preventing and managing complications. Preoperative attention to vascular blood supply, dosing constraints, and systemic risk factors for hemorrhage and infection can help reduce the occurrence of complications. Similarly, intraoperative adjuncts such as cement augmentation, body warmers, radiofrequency cauterization devices, and intraoperative neurophysiologic monitoring can also mitigate surgical and hardware-related complications. Each patient should ultimately be evaluated on a case-by-case basis for the ideal treatment strategy. © 2019 Elsevier Inc. All rights reserved. |
