TY - JOUR T1 - Modern Techniques in the Treatment of Patients with Metastatic Spine Disease AU - Kim, Han Jo AU - Buchowski, Jacob M. AU - Moussallem, Charbel D. AU - Rose, Peter S. Y1 - 2012/05/16 N1 - 10.2106/JBJS.L00192 JO - The Journal of Bone & Joint Surgery SP - 943 EP - 951 VL - 94 IS - 10 N2 - 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. SN - 0021-9355 M3 - doi: 10.2106/JBJS.L00192 UR - http://dx.doi.org/10.2106/JBJS.L00192 ER -