RT Journal
A1 Kim, Han Jo
A1 Buchowski, Jacob M.
A1 Moussallem, Charbel D.
A1 Rose, Peter S.
T1 Modern Techniques in the Treatment of Patients with Metastatic Spine Disease
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD May 16
VO 94
IS 10
SP 943
OP 951
DO 10.2106/JBJS.L00192
UL http://dx.doi.org/10.2106/JBJS.L00192
AB 
The surgical management of metastatic disease of the spine continues to evolve. For most of the recent three decades, radiation therapy provided the mainstay of treatment for patients with symptomatic metastatic disease of the spine. Surgical treatment during this era often involved dorsal spinal cord decompression with no or limited spinal instrumentation1,2. These procedures generally provided only an indirect decompression of the spinal cord and often increased spinal instability. However, with advances in the understanding of metastatic processes in the spine and evolution of surgical techniques and instrumentation, surgical treatment plays a prominent role in the care of patients with metastatic epidural spinal cord compression. Studies have now yielded Level-I evidence on the efficacy of surgery for metastatic disease of the spine for improving quality of life and outcomes in patients with spinal metastasis. Concurrently, advances in radiation oncology now allow high-precision targeting of tumors and increased efficacy when treating radioresistant lesions3. These advances together have led to important advances in the treatment of metastatic disease of the spine.