General Editor: Luiz Vialle

Authors: Ilya Laufer, JJ Verlaan (on behalf of AOSpine Knowledge Forum Tumor)

Metastatic tumors

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Glossary

Occipitocervical, unstable, high ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Occipitocervical fusion All C1 and C2 tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Occipitocervical, unstable, low ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Occipitocervical fusion All C1 and C2 tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Occipitocervical, stable, high ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Occipitocervical fusion All C1 and C2 tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Occipitocervical tumor, stable, low ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Conventional radiotherapy Nonmechanical pain, tumor progression Basic surgical experience, no specialized skills Basic equipment only
Stereotactic body radiotherapy Nonmechanical pain, tumor progression in patients with radioresistant tumors and relatively good life expectancy Basic surgical experience, no specialized skills Basic equipment only

Subaxial cervical, unstable, high ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Anterior decompression and stabillzation Single level vertebral body tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior decompression and stabilization C3-C7 Single/multilevel disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior decompression and stabilization C7-T1 Single/multilevel disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior Multilevel disease or circumferential tumors with extensive loss of bone Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Subaxial cervical, unstable, low ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Anterior corpectomy and stabilzation Gross destruction of the vertebral bodies without posterior involvement Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior stabilization C3-C7 Multilevel disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior stabilization C7-T1 Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior Multilevel disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Subaxial cervical, stable, high ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Anterior decompression and stabilization Single level vertebral body tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior decompression and stabilization C3-C7 Multilevel disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior decompression and stabilization C7-T1 Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior Multilevel disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Subaxial cervical tumor, stable, low ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Conventional radiotherapy Nonmechanical pain, tumor progression Basic surgical experience, no specialized skills Basic equipment only
Stereotactic body radiotherapy Nonmechanical pain, tumor progression in patients with radioresistant tumors and relatively good life expectancy Basic surgical experience, no specialized skills Basic equipment only

Thoracolumbar, unstable, high ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Posterior decompression and stabilization Multi- or single-level disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior decompression and stabilization with corpectomy Multi- or single-level disease or circumferential tumors, extensive destruction of the vertebral body requiring anterior reconstruction Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior MIS Multi- or single-level disease or circumferential tumors and no significant neurological deficit Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior corpectomy and stabilization T6-L5 Single level vertebral body tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior Anterior or posterior fixation alone does not provide sufficient stability (circumferential tumors) Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Thoracolumbar, unstable, low ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Posterior stabilization Multi- or single-level disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior MIS Multi- or single-level disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Kyphoplasty Painful compression fractures secondary to metastatic spine tumors. Some specialized surgical experience Simple surgical and imaging resources
Anterior corpectomy and stabilization T6-L5 Single level vertebral body tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior Multilevel disease or circumferential tumors with extensive bone loss and long life expectancy Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Thoracolumbar, stable, high ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only
Posterior decompression and stabilization Multi- or single-level disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Posterior MIS Multi- or single-level disease or circumferential tumors and no significant neurological deficit Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior corpectomy and stabilization T6-L5 Single level vertebral body tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior Multilevel disease or circumferential tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Thoracolumbar, stable, low ESCC

Please select a treatment option:
Treatment Main indication Skill Equipment
Conventional radiotherapy Nonmechanical pain, tumor progression Basic surgical experience, no specialized skills Basic equipment only
Stereotactic body radiotherapy Nonmechanical pain, tumor progression in patients with radioresistant tumors and relatively good life expectancy Basic surgical experience, no specialized skills Basic equipment only
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

V1.0 2019.01.06