Abstract
The majority of spine tumors encountered by clinicians are metastatic, accounting for approximately 70 % of all spine tumors. Currently a number of treatment modalities are available for treating spinal tumors, including medical therapy, chemotherapy, surgery, radiation therapy, and radiosurgery. This chapter will describe the current role of surgery in the treatment of spinal tumors and the specific factors that make surgery the preferred treatment in a given situation. As with any type of surgery, patient’s age, performance status, life expectancy, and comorbidities must be taken into account when considering operative management for metastatic spine disease. The goals of surgery are neural decompression, making a diagnosis, pain control, stabilization of spine, and/or cure/locoregional tumor control. The surgical approach depends on location of the tumor, patient’s health status and symptoms, and could be anterior, posterior, lateral, or a combination of these. Cement augmentation is also a good option in many cases. Careful patient selection is the key factor for maximizing the potential benefits and avoiding the associated risks of any treatment modality, be it surgery or radiotherapy.