Treatment progress of spinal metastatic cancer: a powerful tool for improving the quality of life of the patients

Journal of Orthopaedic Surgery and Research, 2023 · DOI: https://doi.org/10.1186/s13018-023-03975-3 · Published: July 3, 2023

Oncology

Simple Explanation

Spinal metastasis is a common condition where cancer spreads to the spine, often causing spinal cord and nerve compression. This leads to pain and neurological issues. Treatment is usually focused on managing symptoms to improve the patient's quality of life. Advances in technology and research have led to evolving methods for evaluating and treating spinal metastatic cancer. This includes surgical, minimally invasive, and radiotherapy approaches. The study reviews surgical, minimally invasive, and radiotherapy treatments for spinal metastatic cancer, analyzing their effectiveness, benefits, and limitations.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Systematic Review

Key Findings

1
Open surgery can effectively alleviate pain resulting from spinal cord and nerve root compression, improve neurological symptoms, and correct or prevent vertebral deformities.
2
Minimally invasive treatments, including percutaneous pedicle screw fixation and vertebroplasty, offer reduced tissue damage, less bleeding, and shorter hospital stays.
3
Stereotactic radiotherapy has improved tumor control and reduced side effects associated with radiotherapy.

Research Summary

Spinal metastasis is a common problem for cancer patients, leading to spinal cord and nerve root compression that causes pain and dysfunction. Evaluation systems like SINS and NOMS are increasingly used as the conventional scoring systems become less accurate. Treatment is primarily palliative, with open surgery remaining a key approach for alleviating compression and symptoms. Minimally invasive treatments and stereotactic radiotherapy provide additional options. Future advancements are expected in surgical techniques (less invasive, more beneficial) and decision-making systems (AI-based), along with a growing acceptance of stereotactic radiotherapy for its safety and efficacy.

Practical Implications

Personalized Treatment Plans

Tailoring treatment based on patient condition and life expectancy using scoring systems like NOMS and SINS can optimize outcomes.

Improved Surgical Techniques

Advancements in minimally invasive surgery, laser interstitial thermotherapy, and robotic surgery offer less invasive and more effective options.

Enhanced Radiotherapy

The increasing use of stereotactic body radiotherapy (SBRT) provides better tumor control with reduced side effects compared to conventional radiotherapy.

Study Limitations

1
Conventional scoring systems (Tomita, Tokuhashi) may not accurately reflect improved survival rates due to advancements in primary tumor treatments.
2
Radiotherapy alone may not provide sufficient pain relief if spinal instability is the cause.
3
Lack of standardized radiotherapy regimen for spinal metastatic cancer.

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