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[Translated article] Preoperative assessment and surgical indications: Separation surgery
S Fuentes Caparrós1, F Rodríguez de Tembleque Aguilar1, M Á Marín Luján1
1Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Reina Sofía, Córdoba, Spain.
Spinal metastases can cause neurological compression in 10-20% of patients. Modern treatment focuses on personalized, multidisciplinary care, prioritizing spinal cord release for safe radiosurgery.
Area of Science:
- Oncology
- Neurosurgery
- Radiation Oncology
Background:
- Spinal metastases frequently lead to neurological compression (10-20% of cases).
- Advancements in oncology and surgical techniques necessitate personalized treatment approaches.
Purpose of the Study:
- To outline the evolving multidisciplinary approach for managing neurological compression from spinal metastases.
- To highlight the shift in surgical goals towards facilitating radiosurgery.
Main Methods:
- Review of recent oncological and surgical advancements.
- Analysis of decision-making factors in treatment indication.
- Comparison of historical cytoreductive surgery with current spinal cord release techniques.
Main Results:
- Treatment is now highly personalized, requiring multidisciplinary consensus.
- Key decision factors include patient biology, instability, neurological status, and tumor prognosis.
- Surgical goals have shifted from debulking to ensuring safe spinal cord decompression for radiosurgery.
Conclusions:
- Multidisciplinary, personalized management is crucial for spinal metastases with neurological compression.
- Spinal cord release is the preferred surgical approach to enable effective radiosurgery.
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