Thoracolumbar spinal oncology in the geriatric population Book Section
| Authors: | Goldberg, J. L.; Barzilai, O.; Lockney, D. T.; Amin, A. G.; Bilsky, M. H. |
| Editors: | Fu, K. M. G.; Wang, M. Y.; Virk, M. S.; Dimar, J. R. 2nd; Mummaneni, P. V. |
| Article/Chapter Title: | Thoracolumbar spinal oncology in the geriatric population |
| Abstract: | Advances in cancer-targeted therapies are allowing patients to live longer with cancer. These therapies are less effective against skeletal metastases leading to a potential rise in the incidence of spinal metastases. As the population ages, more elderly patients present with symptomatic spinal metastases. Decision-making for metastatic disease is predicated on the NOMS framework, the Neurologic, Oncologic, Mechanical stability, and Systemic disease/medical comorbidity (NOMS) framework, which principally evaluates four sentinel decision points critical in deciding radiation versus surgery, or both. NOMS synthesizes clinical data to aid in determining the need for surgery. Whereas all assessments are the same regardless of age, the elderly require a very critical analysis of medical comorbidities that impact their ability to tolerate surgery. The development of cancer-specific frailty indices and early involvement of geriatric specialists are critical components in this assessment. Additionally, minimally invasive techniques have improved the ability to tolerate surgical procedures. Incorporating better risk assessments and less invasive techniques has improved outcomes in the elderly population. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. |
| Keywords: | elderly; spine metastases; separation surgery |
| Book Title: | Treatment of Spine Disease in the Elderly: Cutting Edge Techniques and Technologies |
| ISBN: | 978-3-031-12611-6 |
| Publisher: | Springer |
| Publication Place: | Cham, Switzerland |
| Date Published: | 2023-01-01 |
| Start Page: | 339 |
| End Page: | 349 |
| Language: | English |
| DOI: | 10.1007/978-3-031-12612-3_21 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Book chapter: 21 -- MSK author Mark H. Bilsky's affiliation is incorrectly listed as University of California at San Francisco -- Source: Scopus |
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