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Management of Metastatic Spinal Cord Compression Without Stereotactic Radiotherapy and Targeted Adjuvant Chemotherapy

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Metastatic Spine Disease

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Abstract

Metastatic epidural spinal cord compression (MESCC) is defined radiologically as an epidural metastatic lesion causing true displacement of the spinal cord from its normal position in the vertebral canal.

The choice of the most appropriate treatment is of crucial importance for the patient who may be severely disabled by the presence of untreated spinal metastases. These spinal metastases may not only be the cause of severe deterioration in the quality of life but also the direct or indirect cause of death. Bone metastases is an expression of a systemic disease, and therefore a multidisciplinary program, integrating radiotherapy (RT), chemotherapy (CHT), and surgery, is recommended. Our center advocates the designation of a “team leader” who works in strong collaboration with the entire multidisciplinary team. The most appropriate treatment for patients with metastatic disease of the vertebral column is controversial. As the number of patients with MESCC increases, the methods of treatment are also evolving.

Appropriate surgical treatment of bone metastases and tumors in general has now become an integral part of the correct approach to the tumor patient. The evolution of anesthetic techniques now allows more aggressive treatment of some patients with spinal metastases. These procedures can dramatically improve the patient’s quality of life and may prolong the patient’s life expectancy by preventing complications related to paralysis.

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Acknowledgements

The authors thank Mr. Carlo Piovani for his helpful collaboration in patients’ image storage and editing.

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Authors and Affiliations

  1. Department of Oncologic and Degenerative Spine Surgery, Rizzoli Orthopaedic Institute, Bologna, Italy

    Alessandro Gasbarrini MD, Gisberto Evangelisti MD, Riccardo Ghermandi MD, Marco Girolami MD, Guiseppe Tedesco & Valerio Pipola MD

  2. GSpine4 Spine Surgery Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, MI, Italy

    Stefano Boriani MD

Authors
  1. Alessandro Gasbarrini MD
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  2. Gisberto Evangelisti MD
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  3. Riccardo Ghermandi MD
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  4. Marco Girolami MD
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  5. Guiseppe Tedesco
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  6. Valerio Pipola MD
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  7. Stefano Boriani MD
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Correspondence to Stefano Boriani MD .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, Houston Methodist Hospital, Houston, Texas, USA

    Rex A. W. Marco

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Gasbarrini, A. et al. (2018). Management of Metastatic Spinal Cord Compression Without Stereotactic Radiotherapy and Targeted Adjuvant Chemotherapy. In: Marco, R. (eds) Metastatic Spine Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-76252-4_7

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  • DOI: https://doi.org/10.1007/978-3-319-76252-4_7

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