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Management of Metastatic Disease to the Spine: An Evidenced-Based Approach

Finkelstein, Joel A. M.D., F.R.C.S.(C); Yee, Albert M.D., F.R.C.S.(C)

Techniques in Orthopaedics: March 2004 - Volume 19 - Issue 1 - p 30-37
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This article provides an approach to patient selection and treatment options for management of the patient with metastatic disease to the spine. Surgery is only a single tool in the armamentarium of treatment. Treatment is multifactorial, and a collaborative approach needs to be taken in devising the optimal treatment plan for a given patient. With evidenced-based treatment protocols, the highest quality of remaining life can be obtained for these patients. This article is divided into: section I, which addresses patient selection and evaluates functional outcomes after surgery. Section II discusses specific treatments, both surgical and radiation therapy. Section III discusses minimally invasive treatment (percutaneous vertebroplasty) and introduces future directions.

From the Department of Surgery, University of Toronto, Division of Orthopaedic Surgery, Sunnybrook and Women's College Health Sciences Center, Toronto, Ontario, Canada.

Address correspondence and reprint requests to Joel A. Finkelstein, MD, FRCS©, Department of Surgery, University of Toronto, Division of Orthopaedic Surgery, Sunnybrook and Women's College Health Sciences Center, 2075 Bayview Avenue, Rm. MG 301, Toronto, Ontario M4N 3M5, Canada. E-mail: joel.finkelstein@utoronto.ca

© 2004 Lippincott Williams & Wilkins, Inc.