Management of Metastatic Spine Disease

The incidence of primary cancer increases with each passing year, and patients are living longer as a result of improved therapies and interdisciplinary management. Consequently, long-term complications such as debilitating spinal metastases are becoming more prevalent. In this review, the mechanism of metastasis, clinical presentation, and imaging modalities are briefly summarized. Then, various surgical options, radiotherapies, vertebral augmentation procedures, and systemic therapies are described, including recent, clinically-relevant statistics. Currently, the treatment of spinal metastases is palliative and ideally involves a multidisciplinary approach across various specialties. The number of available treatments continues to grow, resulting in paradigm shifts. Only by determining the niche of each therapy can physicians provide the optimal regimen for patients with metastatic spine disease.