[Surgical Management of Metastatic Spinal Tumors]

Historically, metastatic spinal tumors have been treated using open spinal fixation, invasive decompressive techniques, and low-dose palliative conventional external beam radiotherapy. As patients with metastatic disease are now living longer, the need for long-term local tumor control is becoming important. Spine stereotactic body radiotherapy has emerged as a valuable alternative option to achieve long-term local tumor control by delivering high doses of radiation to tumors and sparing the spinal cord. In recent years, minimally invasive spinal fixation and less-invasive decompressive techniques, such as separation surgery, have become increasingly important in the management of metastatic spinal tumors. In this review, we discuss the indications for these therapeutic options and the variables that should be considered when managing these patients.