An update in the management of spinal metastases Journal Article
| Authors: | Joaquim, A. F.; Powers, A.; Laufer, I.; Bilsky, M. H. |
| Article Title: | An update in the management of spinal metastases |
| Abstract: | The best clinical treatment for spinal metastases requires an integrated approach with input from an interdisciplinary cancer team. The principle goals of treatment are maintenance or improvement in neurologic function and ambulation, spinal stability, durable tumor control, and pain relief. The past decade has witnessed an explosion of new technologies that have impacted our ability to reach these goals, such as separation surgery and minimally invasive spinal procedures. The biggest advance, however, has been the evolution of stereotactic radiosurgery that has demonstrated durable tumor control both when delivered as definitive therapy and as a postoperative adjuvant even for tumors considered markedly resistant to conventional external beam radiation. In this paper, we perform an update on the management of spinal metastases demonstrating the integration of these new technologies into a decision framework NOMS that assesses four basic aspects of a patient’s spine disease: Neurologic, Oncologic, Mechanical Instability and Systemic disease. © 2015, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved. |
| Keywords: | clinical feature; review; sorafenib; treatment; gadolinium; nuclear magnetic resonance imaging; medical decision making; opiate; dexamethasone; pneumocystis pneumonia; kidney carcinoma; algorithm; nonsteroid antiinflammatory agent; diagnosis; spinal cord compression; computer assisted emission tomography; scoring system; radiosensitivity; external beam radiotherapy; cotrimoxazole; neurologic disease; neuropathic pain; management; spinal cord metastasis; gabapentin; tricyclic antidepressant agent; bone metastases; randomized controlled trial (topic); spinal metastases; minimally invasive procedure; spine instability; spine radiography; systemic disease; percutaneous vertebroplasty; multicenter study (topic); spinal cord biopsy; human; noms |
| Journal Title: | Arquivos de Neuro-Psiquiatria |
| Volume: | 73 |
| Issue: | 9 |
| ISSN: | 0004-282X |
| Publisher: | Association Arquivos Neuro-Psiquiatria |
| Date Published: | 2015-09-01 |
| Start Page: | 795 |
| End Page: | 802 |
| Language: | English |
| DOI: | 10.1590/0004-282x20150099 |
| PROVIDER: | scopus |
| PUBMED: | 26352500 |
| DOI/URL: | |
| Notes: | Export Date: 2 October 2015 -- Source: Scopus |
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