Diagnosis and treatment of vertebral column metastases

Robert D. Ecker, Toshiki Endo, Nicholas M. Wetjen, William E. Krauss

Research output: Contribution to journalReview article

76 Citations (Scopus)

Abstract

The vertebral column is recognized as the most common site for bony metastases in patients with systemic malignancy. Patients with metastatic spinal tumors may present with pain, neurologic deficit, or both. Some tumors are asymptomatic and are detected during screening examinations. Treatment options include medical therapy, surgery, and radiation. However, diversity of patient condition, tumor pathology, and anatomical extent of disease complicate broad generalizations for treatment. Historically, surgery was considered the most appropriate initial therapy in patients with spinal metastasis with the goal of eradication of gross disease. However, such an aggressive approach has not been practical for many patients. Now, operative intervention is often palliative, with pain control and maintenance of function and stability the major goals. Surgery is reserved for neurologic compromise, radiation failure, spinal instability, or uncertain diagnosis. Recent literature has revealed that surgical outcomes have improved with advances in surgical technique, including refinement of anterior, lateral, posterolateral, and various approaches to the anterior spine, where most metastatic disease is located. We review these surgical approaches for which a team of surgeons often is needed, including neurosurgeons and orthopedic, general, vascular, and thoracic surgeons. Overall, a multimodality approach is useful in caring for these patients. It is important that clinicians are aware of the various therapeutic options and their indications. The optimal treatment of individual patients with spinal metastases should include consideration of their neurologic status, anatomical extent of disease, general health, age, and quality of life.

Original languageEnglish (US)
Pages (from-to)1177-1186
Number of pages10
JournalMayo Clinic Proceedings
Volume80
Issue number9
StatePublished - 2005

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Spine
Neoplasm Metastasis
Nervous System
Therapeutics
Neoplasms
Disease Eradication
Pain
Neurologic Manifestations
Orthopedics
Blood Vessels
Radiotherapy
Thorax
Maintenance
Quality of Life
Radiation
Pathology
Health
Surgeons

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ecker, R. D., Endo, T., Wetjen, N. M., & Krauss, W. E. (2005). Diagnosis and treatment of vertebral column metastases. Mayo Clinic Proceedings, 80(9), 1177-1186.

Diagnosis and treatment of vertebral column metastases. / Ecker, Robert D.; Endo, Toshiki; Wetjen, Nicholas M.; Krauss, William E.

In: Mayo Clinic Proceedings, Vol. 80, No. 9, 2005, p. 1177-1186.

Research output: Contribution to journalReview article

Ecker, RD, Endo, T, Wetjen, NM & Krauss, WE 2005, 'Diagnosis and treatment of vertebral column metastases', Mayo Clinic Proceedings, vol. 80, no. 9, pp. 1177-1186.
Ecker RD, Endo T, Wetjen NM, Krauss WE. Diagnosis and treatment of vertebral column metastases. Mayo Clinic Proceedings. 2005;80(9):1177-1186.
Ecker, Robert D. ; Endo, Toshiki ; Wetjen, Nicholas M. ; Krauss, William E. / Diagnosis and treatment of vertebral column metastases. In: Mayo Clinic Proceedings. 2005 ; Vol. 80, No. 9. pp. 1177-1186.
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