Separation surgery for spinal metastases: Effect of spinal radiosurgery on surgical treatment goals Journal Article

  


Authors: Moussazadeh, N.; Laufer, I.; Yamada, Y.; Bilsky, M. H.
Article Title: Separation surgery for spinal metastases: Effect of spinal radiosurgery on surgical treatment goals
Abstract: Background: The treatment of epidural spinal cord compression due to metastatic cancer represents an important clinical challenge. The NOMS (neurologic, oncologic, mechanical, and systemic) framework facilitates the determination of the optimal combination of systemic, radiation, and surgical therapies for individual patients. Spinal stereotactic radiosurgery (SRS) is an effective and safe modality for achieving durable control of local disease. Integrating SRS into the postoperative treatment plan allows surgical goals to be modified, thus decreasing the extent of tumor resection required. Methods: Separation surgery is indicated for patients with spinal cord compression secondary to solid tumor metastases. During separation surgery, the spinal column is stabilized and the epidural tumor is resected without requiring significant vertebral body resection. Results: Tumor separation from the spinal cord allows patients to undergo postoperative SRS. Conclusions: The combination of separation surgery and high-dose hypofractionated or single-fraction SRS results in high local tumor control at 1 year and is an effective palliative paradigm for this patient population.
Keywords: cancer survival; treatment response; surgical technique; survival rate; overall survival; multimodality cancer therapy; treatment duration; cancer adjuvant therapy; radiation dose; cancer staging; progression free survival; tumor volume; prevalence; spinal cord compression; brachytherapy; radiosensitivity; safety; clinical effectiveness; stereotactic radiosurgery; external beam radiotherapy; spinal cord metastasis; spine surgery; randomized controlled trial (topic); human; article; separation surgery
Journal Title: Cancer Control
Volume: 21
Issue: 2
ISSN: 1073-2748
Publisher: H. Lee Moffitt Cancer Center & Research Institute  
Date Published: 2014-04-01
Start Page: 168
End Page: 174
Language: English
PROVIDER: scopus
PUBMED: 24667404
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84896998540&partnerID=40&md5=6f9aa734ab56cf9598be858b2ec36587
Notes: Export Date: 1 May 2014 -- CODEN: CACOF -- Source: Scopus
Citation Impact
What is Dimensions Citation Badge?
MSK Authors
  1. Yoshiya Yamada
    479 Yamada
  2. Mark H Bilsky
    319 Bilsky
  3. Ilya Laufer
    146 Laufer
  4. Nelson Moss
    88 Moss
Related MSK Work