Summary of Key Points Radiosurgery is safe and effective, with durable symptomatic response and local control for even radioresistant histologies, regardless of prior fractionated radiotherapy. The ability to deliver cytotoxic doses to the tumor while sparing normal tissue offers a…
Summary of Key Points Percutaneous computed tomography–guided biopsy should be performed in patients when diagnosis may influence the decision to proceed with surgery or the extent of surgery. It is critical that wide negative margins are obtained in tumor resection.…
Summary of Key Points Primary spinal tumors in the thoracic and lumbar region are uncommon, but they represent tumors that may have the potential for a cure. Metastatic tumors in this region, however, represent an advanced stage of primary cancer.…
Summary of Key Points The cervicothoracic junction (CTJ) is subject to unique biomechanical stresses because it is the transitional zone between the cervical and thoracic spine, and lesions in this area can lead to progressive instability, resulting in kyphosis and…
Summary of Key Points A wide array of benign and malignant tumors can arise in the region of the foramen magnum and craniocervical junction. These can be intradural or extradural tumors. The most common symptoms of foramen magnum tumors are…
Summary of Key Points The NOMS framework consists of four considerations (neurological, oncological, mechanical, and systemic) and facilitates decision making for patients with metastatic spine tumors. Conventional external beam radiation provides local tumor control in patients with radiosensitive tumors, whereas…
Summary of Key Points Establishing histopathological diagnosis is critical to understanding the natural history, aggressiveness, and likelihood of the tumor to respond to chemotherapy, radiation, or other adjuvant treatments. Once accurate diagnosis is established, surgical planning requires knowledge of the…
Summary of Key Points Failed back surgery syndrome is an evolving diagnosis characterized by chronic pain after surgical intervention. Pathophysiology is varied, but is based on abnormal pain signaling from damaged or dysfunctional nerves. Involvement of the limbic system in…
Summary of Key Points Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease characterized by inflammatory back pain and potential progression to disability and deformity. Clinical characteristics of inflammatory back pain can be distinguished from other causes of chronic back…
Summary of Key Points Dysplastic spondylolisthesis is a developmental disorder of the spine that is associated with significant pain and disability. Sacropelvic and spinopelvic balance are important determinants of the impact of spondylolisthesis on health status. Reduction of high-grade dysplastic…