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A Preclinical Murine Model of Hepatic Metastases
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Management - spinal metastases.

Anick Nater1, Arjun Sahgal2, Michael Fehlings1

  • 1Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.

Handbook of Clinical Neurology
|January 9, 2018
PubMed
Summary
This summary is machine-generated.

Symptomatic vertebral metastases are increasing due to cancer incidence and longer life expectancy. Early diagnosis and treatment of spinal metastases improve patient quality and length of life.

Keywords:
clinical featuresdiagnosisepidemiologyexternal-beam radiotherapy (EBRT)intramedullary spinal cord metastasis (MSCM)managementmetastatic epidural spinal cord compression (MESCC)minimally invasive spine surgery (MISS)stereotactic body radiotherapy (SBRT)surgery

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Area of Science:

  • Oncology
  • Neurosurgery
  • Radiotherapy

Background:

  • Increasing cancer incidence and patient longevity lead to more symptomatic vertebral metastases.
  • Spinal metastases cause severe pain, neurological deficits (paralysis, sensory loss), and incontinence.
  • Prompt diagnosis and treatment are crucial for improving quality of life and survival in metastatic cancer patients.

Purpose of the Study:

  • To provide a comprehensive overview of vertebral metastases, including epidural and intramedullary spinal types.
  • To discuss epidemiology, pathophysiology, demographics, clinical presentation, diagnosis, and management strategies.
  • To review the evolution of treatment options and decision-making tools for spinal metastases.

Main Methods:

  • Review of epidemiological data and pathophysiology of spinal metastases.
  • Analysis of clinical presentation, diagnostic approaches, and management options.
  • Summary of treatment evolution from conventional radiation to stereotactic body radiotherapy and open surgery to minimally invasive spine surgery.
  • Review of clinical prediction rules, frameworks, algorithms, and guidelines for treatment decision-making.

Main Results:

  • Vertebral metastases present significant challenges due to potential for severe pain and neurological compromise.
  • Treatment has evolved from traditional methods to more advanced techniques like stereotactic radiotherapy and minimally invasive surgery.
  • Clinical guidelines and decision-making tools are essential for optimizing patient care.

Conclusions:

  • Effective management of vertebral metastases requires a multidisciplinary approach.
  • Advancements in radiotherapy and spine surgery offer improved outcomes for patients with spinal metastases.
  • Standardized clinical guidelines aid in navigating complex treatment decisions for spinal metastases.