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Methods: A systematic literature search in PubMed and MEDLINE, and was performed from 2013 to 2023 using the search terms \u201ccomplications\u201d + \u201cspine metastases\u201d, \u201cspine metastases\u201d + + \u201crehabilitation\u201d, \u201cspine metastases\u201d + \u201cpain therapy\u201d + \u201cpalliative care\u201d. Screening criteria resulted in 35, 15 and 56 studies respectively that were analyzed. Using the Delphi method and two rounds of voting at two separate international meetings, nine members of the WFNS (World Federation of Neurosurgical Societies) Spine Committee generated nine final consensus statements. Results: Preoperative assessment for complications following surgery in patients with metastatic spine tumors should include estimation of Karnofsky score, site of primary tumor, number of spinal and visceral metastasis, ASA score and preoperative Hb (Hemoglobin) value. Complication risk factors are age\u2009&gt;\u200965 years, preoperative ASA score of 3 and 4 and greater operative blood loss. Pain management using WHO analgesic concept and early mobilization are needed, starting with non-opioids, weak opioids followed by strong opioids. Morphine is the first choice for moderate to severe pain whereas IV-PCA may be used for severe breakthrough pain with monitoring. Use of bisphosphonates is considered in cases of non-localized pain and not accessible radiation therapy. Conclusions: These nine final consensus statements provide current, evidence-based guidelines on complication avoidance, rehabilitation, pain therapy and palliative care for patients with spinal metastases.<\/jats:p>","DOI":"10.1007\/s10143-024-03050-3","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T14:55:42Z","timestamp":1730300142000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors: WFNS spine committee recommendations"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6123-5589","authenticated-orcid":false,"given":"Mirza","family":"Pojskic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sait","family":"Naderi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Vaishya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0448-3121","authenticated-orcid":false,"given":"Mehmet","family":"Zileli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5191-9477","authenticated-orcid":false,"given":"Francesco","family":"Costa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3332-1789","authenticated-orcid":false,"given":"Salman","family":"Sharif","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziya L.","family":"Gokaslan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"3050_CR1","doi-asserted-by":"publisher","first-page":"100446","DOI":"10.1016\/j.jbo.2022.100446","volume":"35","author":"R Van den Brande","year":"2022","unstructured":"Van den Brande R, Cornips EM, Peeters M, Ost P, Billiet C, Van de Kelft E (2022) Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: a systematic review. 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