Treatment of Metastatic Spinal Disease; what the Radiologist needs to know

Abstract

Advancements in technology and multidisciplinary management have revolutionized the treatment of spinal metastases. Imaging plays a pivotal role in determining the treatment course for spinal metastases. This article aims to review the relevant imaging findings in spinal metastases from the perspective of the treating clinician, describe the various treatment options, and discuss factors influencing choice for each available treatment option. Cases that once required radical surgical resection or low-dose conventional external beam radiation therapy (EBRT), or both, are now being managed with separation surgery, spine stereotactic radiosurgery(SRS)/stereotactic body radiation therapy (SBRT), or both, with decreased morbidity, improved local control, and more durable pain control. The primary focus in determining treatment choice is now on tumor control outcomes, treatment-related morbidity, and quality of life.

Multiple Myeloma Treatment Challenges: A Case Report of Vertebral Artery Pseudoaneurysm Complicating Occipitocervical Arthrodesis and a Review of the Literature

“…Therefore, it is crucial to prevent this complication and know how to investigate it upon suspicion of vertebral artery (VA) injury [12][13][14][15][16]. Imaging studies play a fundamental role in determining the course of treatment [17]. Another critical aspect is the anatomy of the vertebrobasilar system; the anatomical variants of the VA must be known, as their presence may increase the risk of iatrogenic injury to the VA [18].…”