Holistic Approach to the Diagnosis and Treatment of Patients with Tumor Metastases to the Spine

Abstract

The treatment of neoplastic spine metastases requires multi-faceted assessment and an interdisciplinary approach to patients. The metastases do not show specific symptoms but are often the first confirmation of the presence of a primary tumor in a patient. The diagnostic process includes imaging and invasive procedures, e.g., biopsy. It is essential to qualify the patient for an appropriate treatment using dedicated scales. Decompression of the spinal cord is a critical issue to save or restore neurological function in a patient with spine metastases. Surgical treatment ought to meet three criteria: release spinal cord and nerve roots, restore the spine’s anatomical relations, and ensure the internal stabilization of the spine. A good result from surgical treatment enables the continuation of radiotherapy, chemotherapy, hormone therapy, and targeted molecular therapy. Stereotactic radiosurgery and stereotactic body radiotherapy are more effective ways of treating spine metastases than conventional external beam radiotherapy. They allow higher doses of radiation, concentrated precisely at the tumor site. Our review summarizes the established and emerging concepts in the treatment of spine metastases. A holistic approach to the patient enables the selection of the appropriate therapy.

Measuring the paraspinal muscles as an important tool for predicting the overall survival period after spine surgery in lung cancer patients with spine metastasis

“…Therefore, the performance status, such as the Karnofsky scale or Eastern Cooperative Oncology Group performance status, is preoperatively considered in determining whether to perform the surgical treatment. (15) The degree of performance status is known to be closely related to the paraspinal muscles. (16,17) In this study, the authors rst analyzed the correlation between the paraspinal muscles and prognosis after spine surgery in lung cancer patients.…”

CRISPR, CAR-T, and NK: Current applications and future perspectives

“… 52 , 53 , 54 Due to the treatment complications and different cancer cell reactions with various treatments, it is very important to choose the most appropriate therapy method based on the patient's condition. 55 , 56 One of the most effective and promising methods is CAR-T cell therapy. 57 , 58 CAR-T cell therapy is a kind of immunotherapy in which, using the ability of immune cells to identify foreign agents, it is possible to kill cancerous cells without harming other normal cells in the body.…”

Automating Structured Results Communication to Expedite Imaging-Directed Care in Spine Oncology

“…Spinal metastases can cause severe pain due to nerve compression or vertebral collapse, and can result in paralysis due to compression of the spinal cord. The proper management of patients requires a timely multi-specialty approach [2,3]. Therefore, it is important that spinal metastases be communicated promptly to the physicians who can manage the disease.…”