Surgical Management of Spine and Spinal Cord Metastasis

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Background

The management of spine and spinal cord metastasis represents a complex and evolving field that requires a multidisciplinary approach involving neurosurgeons, spine surgeons, and medical and radiation oncologists, among many others. Metastatic tumors involving the spine and spinal cord are a common manifestation of advanced cancer, with a significant impact on patient quality of life and neurological function. Surgical intervention plays a pivotal role in the comprehensive management of spine and spinal cord metastasis. Surgical approaches aim to relieve pain, stabilize the spine, and decompress neural elements, with the ultimate goal of preserving or restoring neurological function. The advancements in surgical techniques, including minimally invasive approaches and image-guided navigation systems, have enhanced surgical precision while minimizing morbidity. Collaboration between surgeons and oncologists is crucial in tailoring treatment strategies for individual patients. A comprehensive understanding of the underlying oncological disease, including its primary origin and systemic burden, guides treatment decisions. The integration of surgery with radiation therapy, other systemic therapies (chemotherapy and immune therapy) and palliative care optimizes patient outcomes and improves overall survival.

Despite significant advancements in oncological treatments, the management of spinal metastasis remains a formidable challenge, often leading to debilitating pain, neurological deficits, and decreased survival rates. While notable progress has been made in medical aspects of treatment, including radiation and chemotherapeutic agents, which have resulted in longer survival times and improved outcomes, it is crucial to continuously review and update the surgical aspect of care. This research topic aims to explore innovative surgical techniques that optimize patient care. Recent breakthroughs in surgical approaches and imaging modalities, such as minimally invasive spine surgery, intraoperative MRI, and navigational systems, have brought about a revolution in the precision and safety of surgical interventions. These advancements enable more accurate tumor localization, precise resection, and improved spinal stability. The integration of novel surgical techniques with emerging targeted therapies and immunotherapies holds tremendous potential for enhancing treatment efficacy and improving long-term outcomes. By focusing on this research topic, we can help bridge the existing gap in understanding and provide evidence-based recommendations for the surgical management of spine and spinal cord metastasis. These advances will directly impact patient care by facilitating personalized treatment strategies and yielding improved functional outcomes. Ultimately, this research will contribute to enhancing the quality of life and survival rates of patients with spinal metastasis, benefiting both the neurosurgery and oncology communities. Continuous refinement and innovation in surgical management are essential to ensure the best possible outcomes for this challenging patient population.

The current research topic encompasses several key areas of investigation, including, but not limited to:



1) Evaluation of Surgical Techniques: This research aims to examine the outcomes of various surgical techniques employed in the care of patients with spine metastases. These techniques may include separation surgery, decompression and fusion procedures, vertebroplasty, kyphoplasty, and other relevant interventions.

2) Minimally Invasive Approaches: The research topic also explores the use of minimally invasive approaches for managing spine metastasis. This includes investigating the benefits and limitations of minimally invasive surgical techniques in terms of tumor resection, functional outcomes, patient recovery, and overall survival.

3) Comparative Analysis of Approaches: Additionally, this research topic seeks to identify and compare the outcomes associated with different surgical approaches for spine metastasis. By examining the variations in patient outcomes, such as pain relief, neurological recovery, and quality of life, we can elucidate the advantages and disadvantages of each approach.



By addressing these specific areas of investigation, this research topic aims to enhance our understanding of the surgical management of spine and spinal cord metastasis. The findings will provide valuable insights into optimizing patient care, improving functional outcomes, and ultimately contributing to enhanced quality of life for this patient population. Manuscripts that are primarily bioinformatics-based/in silico studies will not be considered unless there is validation in an independent clinical patient cohort or functional validation in vitro and/or in vivo using relevant cancer cell line models.

Keywords: Spine metastasis, spinal cord metastasis, surgery, survival, minimally invasive surgery

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