{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T12:33:09Z","timestamp":1768739589423,"version":"3.49.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Augsburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Current treatment of spinal metastases (SM) aims on preserving spinal stability, neurological status, and functional status as well as achieving local control. It consists of spinal surgery followed by radiotherapy and\/or systemic treatment. Adjuvant therapy usually starts with a delay of a few weeks to prevent wound healing issues. Intraoperative radiotherapy (IORT) has previously been successfully applied during brain tumor, breast and colorectal carcinoma surgery but not in SM, including unstable one, to date. In our case series, we describe the feasibility, morbidity and mortality of a novel treatment protocol for SM combining stabilization surgery with IORT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Single center case series on patients with SM. Single session stabilization by navigated open or percutaneous procedure using a carbon screw-rod system followed by concurrent 50\u00a0kV photon-IORT (ZEISS Intrabeam). The IORT probe is placed via a guide canula using navigation, positioning is controlled by IOCT or 3D-fluroscopy enabling RT isodose planning in the OR.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>15 (8 female) patients (71\u2009\u00b1\u200910y) received this treatment between 07\/22 and 09\/23. Median Spinal Neoplastic Instability Score was 8 [7\u201310] IQR. Most metastasis were located in the thoracic (<jats:italic>n<\/jats:italic>\u2009=\u200911, 73.3%) and the rest in the lumbar (<jats:italic>n<\/jats:italic>\u2009=\u20094, 26.7%) spine. 9 (60%) patients received open, 5 (33%) percutaneous stabilization and 1 (7%) decompression only. Mean length of surgery was 157\u2009\u00b1\u200945\u00a0min. Eleven patients had 8 and 3 had 4 screws placed. In 2 patients radiotherapy was not completed due to bending of the guide canula with consecutive abortion of IORT. All other patients received 8\u00a0Gy isodoses at mdn. 1.5\u00a0cm [1.1\u20131.9, IQR] depth during 2-6\u00a0min. The patients had Epidural Spinal Cord Compression score 1a-3. Seven patients (46.7%) experienced adverse events including 2 surgical site infection (one 65\u00a0days after surgery).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>50\u00a0kV photon IORT for SM and consecutive unstable spine needing surgical intervention is safe and feasible and can be a promising technique in selected cases.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11060-024-04688-1","type":"journal-article","created":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T07:02:06Z","timestamp":1713855726000},"page":"445-455","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intraoperative radiotherapy combined with spinal stabilization surgery\u2014a novel treatment strategy for spinal metastases based on a first single-center experiences"],"prefix":"10.1007","volume":"168","author":[{"given":"P.","family":"Krauss","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. L.","family":"Wolfert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Sommer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Stemmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Stueben","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. H.","family":"Kahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Shiban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,23]]},"reference":[{"key":"4688_CR1","doi-asserted-by":"publisher","first-page":"2849","DOI":"10.1097\/01.brs.0000245838.37817.40","volume":"31","author":"A Falicov","year":"2006","unstructured":"Falicov A, Fisher CG, Sparkes J, Boyd MC, Wing PC, Dvorak MF (2006) Impact of surgical intervention on quality of life in patients with spinal metastases. Spine (Phila Pa 1976) 31:2849\u20132856. https:\/\/doi.org\/10.1097\/01.brs.0000245838.37817.40","journal-title":"Spine (Phila Pa 1976)"},{"key":"4688_CR2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/canjclin.50.1.7","volume":"50","author":"RT Greenlee","year":"2000","unstructured":"Greenlee RT, Murray T, Bolden S, Wingo PA (2000) Cancer statistics, 2000. CA Cancer J Clin 50:7\u201333. https:\/\/doi.org\/10.3322\/canjclin.50.1.7","journal-title":"CA Cancer J Clin"},{"key":"4688_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta17420","volume":"17","author":"P Sutcliffe","year":"2013","unstructured":"Sutcliffe P, Connock M, Shyangdan D, Court R, Kandala NB, Clarke A (2013) A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression. Health Technol Assess 17:1\u2013274. https:\/\/doi.org\/10.3310\/hta17420","journal-title":"Health Technol Assess"},{"key":"4688_CR4","doi-asserted-by":"publisher","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. J Bone Oncol 35:100446. https:\/\/doi.org\/10.1016\/j.jbo.2022.100446","journal-title":"J Bone Oncol"},{"key":"4688_CR5","doi-asserted-by":"publisher","first-page":"2419","DOI":"10.1200\/JCO.2017.72.7362","volume":"35","author":"O Barzilai","year":"2017","unstructured":"Barzilai O, Laufer I, Yamada Y, Higginson DS, Schmitt AM, Lis E, Bilsky MH (2017) Integrating Evidence-Based Medicine for Treatment of Spinal Metastases Into a Decision Framework: Neurologic, Oncologic, Mechanicals Stability, and Systemic Disease. J Clin Oncol 35:2419\u20132427. https:\/\/doi.org\/10.1200\/JCO.2017.72.7362","journal-title":"J Clin Oncol"},{"key":"4688_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2020.100320","volume":"25","author":"G Di Perna","year":"2020","unstructured":"Di Perna G, Cofano F, Mantovani C, Badellino S, Marengo N, Ajello M, Comite LM, Palmieri G, Tartara F, Zenga F, Ricardi U, Garbossa D (2020) Separation surgery for metastatic epidural spinal cord compression: A qualitative review. J Bone Oncol 25:100320. https:\/\/doi.org\/10.1016\/j.jbo.2020.100320","journal-title":"J Bone Oncol"},{"key":"4688_CR7","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.spinee.2017.07.008","volume":"18","author":"I Hussain","year":"2018","unstructured":"Hussain I, Barzilai O, Reiner AS, DiStefano N, McLaughlin L, Ogilvie S, Bilsky M, Laufer I (2018) Patient-reported outcomes after surgical stabilization of spinal tumors: symptom-based validation of the Spinal Instability Neoplastic Score (SINS) and surgery. Spine J 18:261\u2013267. https:\/\/doi.org\/10.1016\/j.spinee.2017.07.008","journal-title":"Spine J"},{"key":"4688_CR8","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1200\/JCO.2000.18.3.584","volume":"18","author":"M Colleoni","year":"2000","unstructured":"Colleoni M, Bonetti M, Coates AS, Castiglione-Gertsch M, Gelber RD, Price K, Rudenstam CM, Lindtner J, Collins J, Thurlimann B, Holmberg S, Veronesi A, Marini G, Goldhirsch A (2000) Early start of adjuvant chemotherapy may improve treatment outcome for premenopausal breast cancer patients with tumors not expressing estrogen receptors. The International Breast Cancer Study Group. J Clin Oncol 18:584\u2013590. https:\/\/doi.org\/10.1200\/JCO.2000.18.3.584","journal-title":"J Clin Oncol"},{"key":"4688_CR9","doi-asserted-by":"publisher","first-page":"3080","DOI":"10.1007\/s00586-020-06478-5","volume":"29","author":"N Kumar","year":"2020","unstructured":"Kumar N, Madhu S, Bohra H, Pandita N, Wang SSY, Lopez KG, Tan JH, Vellayappan BA (2020) Is there an optimal timing between radiotherapy and surgery to reduce wound complications in metastatic spine disease? A systematic review. Eur Spine J 29:3080\u20133115. https:\/\/doi.org\/10.1007\/s00586-020-06478-5","journal-title":"Eur Spine J"},{"key":"4688_CR10","doi-asserted-by":"publisher","first-page":"9595","DOI":"10.1038\/s41598-020-66608-3","volume":"10","author":"I Zur","year":"2020","unstructured":"Zur I, Tzuk-Shina T, Guriel M, Eran A, Kaidar-Person O (2020) Survival impact of the time gap between surgery and chemo-radiotherapy in Glioblastoma patients. Sci Rep 10:9595. https:\/\/doi.org\/10.1038\/s41598-020-66608-3","journal-title":"Sci Rep"},{"key":"4688_CR11","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1007\/s00066-022-02003-3","volume":"198","author":"KH Kahl","year":"2022","unstructured":"Kahl KH, Shiban E, Gutser S, Maurer CJ, Sommer B, Muller H, Konietzko I, Grossert U, Berlis A, Janzen T, Stuben G (2022) Focal cavity radiotherapy after neurosurgical resection of brain metastases: sparing neurotoxicity without compromising locoregional control. Strahlenther Onkol 198:1105\u20131111. https:\/\/doi.org\/10.1007\/s00066-022-02003-3","journal-title":"Strahlenther Onkol"},{"key":"4688_CR12","doi-asserted-by":"publisher","first-page":"1071804","DOI":"10.3389\/fsurg.2022.1071804","volume":"9","author":"P Krauss","year":"2022","unstructured":"Krauss P, Steininger K, Motov S, Sommer B, Bonk MN, Cortes A, Wolfert C, Stueben G, Shiban E, Kahl KH (2022) Resection of supratentorial brain metastases with intraoperative radiotherapy. Is it safe? Analysis and experiences of a single center cohort. Front Surg 9:1071804. https:\/\/doi.org\/10.3389\/fsurg.2022.1071804","journal-title":"Front Surg"},{"key":"4688_CR13","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.suronc.2012.11.001","volume":"22","author":"R Mirnezami","year":"2013","unstructured":"Mirnezami R, Chang GJ, Das P, Chandrakumaran K, Tekkis P, Darzi A, Mirnezami AH (2013) Intraoperative radiotherapy in colorectal cancer: systematic review and meta-analysis of techniques, long-term outcomes, and complications. Surg Oncol 22:22\u201335. https:\/\/doi.org\/10.1016\/j.suronc.2012.11.001","journal-title":"Surg Oncol"},{"key":"4688_CR14","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s13014-016-0749-9","volume":"12","author":"F Sedlmayer","year":"2017","unstructured":"Sedlmayer F, Reitsamer R, Wenz F, Sperk E, Fussl C, Kaiser J, Ziegler I, Zehentmayr F, Deutschmann H, Kopp P, Fastner G (2017) Intraoperative radiotherapy (IORT) as boost in breast cancer. Radiat Oncol 12:23. https:\/\/doi.org\/10.1186\/s13014-016-0749-9","journal-title":"Radiat Oncol"},{"key":"4688_CR15","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1007\/s00586-005-0979-2","volume":"15","author":"T Saito","year":"2006","unstructured":"Saito T, Kondo T, Hozumi T, Karasawa K, Seichi A, Nakamura K (2006) Results of posterior surgery with intraoperative radiotherapy for spinal metastases. Eur Spine J 15:216\u2013222. https:\/\/doi.org\/10.1007\/s00586-005-0979-2","journal-title":"Eur Spine J"},{"key":"4688_CR16","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1748-717X-5-11","volume":"5","author":"F Wenz","year":"2010","unstructured":"Wenz F, Schneider F, Neumaier C, Kraus-Tiefenbacher U, Reis T, Schmidt R, Obertacke U (2010) Kypho-IORT\u2013a novel approach of intraoperative radiotherapy during kyphoplasty for vertebral metastases. Radiat Oncol 5:11. https:\/\/doi.org\/10.1186\/1748-717X-5-11","journal-title":"Radiat Oncol"},{"key":"4688_CR17","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1093\/neuros\/nyx567","volume":"82","author":"O Barzilai","year":"2018","unstructured":"Barzilai O, Fisher CG, Bilsky MH (2018) State of the Art Treatment of Spinal Metastatic Disease. Neurosurgery 82:757\u2013769. https:\/\/doi.org\/10.1093\/neuros\/nyx567","journal-title":"Neurosurgery"},{"key":"4688_CR18","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","volume":"240","author":"D Dindo","year":"2004","unstructured":"Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205\u2013213","journal-title":"Ann Surg"},{"key":"4688_CR19","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1177\/0310057X0203000516","volume":"30","author":"Mak PH, Campbell RC, Irwin MG, American Society of A","year":"2002","unstructured":"Mak PH, Campbell RC, Irwin MG, American Society of A (2002) The ASA Physical Status Classification: inter-observer consistency. American Society of Anesthesiologists. Anaesth Intensive Care 30:633\u2013640. https:\/\/doi.org\/10.1177\/0310057X0203000516","journal-title":"Anaesth Intensive Care"},{"key":"4688_CR20","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1200\/JCO.1984.2.3.187","volume":"2","author":"CC Schag","year":"1984","unstructured":"Schag CC, Heinrich RL, Ganz PA (1984) Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol 2:187\u2013193. https:\/\/doi.org\/10.1200\/JCO.1984.2.3.187","journal-title":"J Clin Oncol"},{"key":"4688_CR21","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1016\/j.spinee.2017.09.011","volume":"18","author":"F Bludau","year":"2018","unstructured":"Bludau F, Welzel G, Reis T, Schneider F, Sperk E, Neumaier C, Ehmann M, Clausen S, Obertacke U, Wenz F, Giordano FA (2018) Phase I\/II trial of combined kyphoplasty and intraoperative radiotherapy in spinal metastases. Spine J 18:776\u2013781. https:\/\/doi.org\/10.1016\/j.spinee.2017.09.011","journal-title":"Spine J"},{"key":"4688_CR22","doi-asserted-by":"publisher","first-page":"i5","DOI":"10.1093\/nop\/npaa046","volume":"7","author":"JT Wewel","year":"2020","unstructured":"Wewel JT, O\u2019Toole JE (2020) Epidemiology of spinal cord and column tumors. Neurooncol Pract 7:i5\u2013i9. https:\/\/doi.org\/10.1093\/nop\/npaa046","journal-title":"Neurooncol Pract"},{"key":"4688_CR23","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1186\/s12885-019-5666-5","volume":"19","author":"F Bludau","year":"2019","unstructured":"Bludau F, Welzel G, Reis T, Abo-Madyan Y, Sperk E, Schneider F, Clausen S, Ruder AM, Obertacke U, Ghaly MM, Wenz F, Giordano FA (2019) Combined kyphoplasty and intraoperative radiotherapy (Kypho-IORT) versus external beam radiotherapy (EBRT) for painful vertebral metastases - a randomized phase III study. BMC Cancer 19:430. https:\/\/doi.org\/10.1186\/s12885-019-5666-5","journal-title":"BMC Cancer"},{"key":"4688_CR24","doi-asserted-by":"publisher","first-page":"2835","DOI":"10.1016\/j.spinee.2014.03.043","volume":"14","author":"M Huisman","year":"2014","unstructured":"Huisman M, van der Velden JM, van Vulpen M, van den Bosch MA, Chow E, Oner FC, Yee A, Verkooijen HM, Verlaan JJ (2014) Spinal instability as defined by the spinal instability neoplastic score is associated with radiotherapy failure in metastatic spinal disease. Spine J 14:2835\u20132840. https:\/\/doi.org\/10.1016\/j.spinee.2014.03.043","journal-title":"Spine J"},{"key":"4688_CR25","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1634\/theoncologist.2016-0356","volume":"22","author":"JM van der Velden","year":"2017","unstructured":"van der Velden JM, Versteeg AL, Verkooijen HM, Fisher CG, Chow E, Oner FC, van Vulpen M, Weir L, Verlaan JJ (2017) Prospective Evaluation of the Relationship Between Mechanical Stability and Response to Palliative Radiotherapy for Symptomatic Spinal Metastases. Oncologist 22:972\u2013978. https:\/\/doi.org\/10.1634\/theoncologist.2016-0356","journal-title":"Oncologist"},{"key":"4688_CR26","doi-asserted-by":"publisher","first-page":"e285","DOI":"10.1016\/j.prro.2018.02.001","volume":"8","author":"DD Shi","year":"2018","unstructured":"Shi DD, Hertan LM, Lam TC, Skamene S, Chi JH, Groff M, Cho CH, Ferrone ML, Harris M, Chen YH, Balboni TA (2018) Assessing the utility of the spinal instability neoplastic score (SINS) to predict fracture after conventional radiation therapy (RT) for spinal metastases. Pract Radiat Oncol 8:e285\u2013e294. https:\/\/doi.org\/10.1016\/j.prro.2018.02.001","journal-title":"Pract Radiat Oncol"},{"key":"4688_CR27","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1634\/theoncologist.2015-0266","volume":"21","author":"AL Versteeg","year":"2016","unstructured":"Versteeg AL, van der Velden JM, Verkooijen HM, van Vulpen M, Oner FC, Fisher CG, Verlaan JJ (2016) The Effect of Introducing the Spinal Instability Neoplastic Score in Routine Clinical Practice for Patients With Spinal Metastases. Oncologist 21:95\u2013101. https:\/\/doi.org\/10.1634\/theoncologist.2015-0266","journal-title":"Oncologist"},{"key":"4688_CR28","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1097\/BRS.0000000000003835","volume":"46","author":"J Wanman","year":"2021","unstructured":"Wanman J, Jernberg J, Gustafsson P, Abul-Kasim K, Grabowski P, Bobinski L, Crnalic S (2021) Predictive Value of the Spinal Instability Neoplastic Score for Survival and Ambulatory Function After Surgery for Metastatic Spinal Cord Compression in 110 Patients with Prostate Cancer. Spine (Phila Pa 1976) 46:550\u2013558. https:\/\/doi.org\/10.1097\/BRS.0000000000003835","journal-title":"Spine (Phila Pa 1976)"},{"key":"4688_CR29","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2023.09.009","author":"JP Te Velde","year":"2023","unstructured":"Te Velde JP, Zijlstra H, Lans A, Patel CG, Raje N, Delawi D, Kempen DHR, Verlaan JJ, van Royen BJ, Schwab JH (2023) Fracture rate after conventional external beam radiation therapy to the spine in multiple myeloma patients. Spine J. https:\/\/doi.org\/10.1016\/j.spinee.2023.09.009","journal-title":"Spine J"},{"key":"4688_CR30","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s11060-019-03309-6","volume":"145","author":"CP Cifarelli","year":"2019","unstructured":"Cifarelli CP, Brehmer S, Vargo JA, Hack JD, Kahl KH, Sarria-Vargas G, Giordano FA (2019) Intraoperative radiotherapy (IORT) for surgically resected brain metastases: outcome analysis of an international cooperative study. J Neurooncol 145:391\u2013397. https:\/\/doi.org\/10.1007\/s11060-019-03309-6","journal-title":"J Neurooncol"},{"key":"4688_CR31","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1093\/neuros\/nyy018","volume":"84","author":"FA Giordano","year":"2019","unstructured":"Giordano FA, Brehmer S, Murle B, Welzel G, Sperk E, Keller A, Abo-Madyan Y, Scherzinger E, Clausen S, Schneider F, Herskind C, Glas M, Seiz-Rosenhagen M, Groden C, Hanggi D, Schmiedek P, Emami B, Souhami L, Petrecca K, Wenz F (2019) Intraoperative Radiotherapy in Newly Diagnosed Glioblastoma (INTRAGO): An Open-Label, Dose-Escalation Phase I\/II Trial. Neurosurgery 84:41\u201349. https:\/\/doi.org\/10.1093\/neuros\/nyy018","journal-title":"Neurosurgery"},{"key":"4688_CR32","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1097\/BRS.0b013e31817c0410","volume":"33","author":"T Kondo","year":"2008","unstructured":"Kondo T, Hozumi T, Goto T, Seichi A, Nakamura K (2008) Intraoperative radiotherapy combined with posterior decompression and stabilization for non-ambulant paralytic patients due to spinal metastasis. Spine (Phila Pa 1976) 33:1898\u20131904. https:\/\/doi.org\/10.1097\/BRS.0b013e31817c0410","journal-title":"Spine (Phila Pa 1976)"},{"key":"4688_CR33","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1007\/s00586-015-4116-6","volume":"25","author":"S Sugita","year":"2016","unstructured":"Sugita S, Hozumi T, Yamakawa K, Goto T, Kondo T (2016) Risk factors for surgical site infection after posterior fixation surgery and intraoperative radiotherapy for spinal metastases. Eur Spine J 25:1034\u20131038. https:\/\/doi.org\/10.1007\/s00586-015-4116-6","journal-title":"Eur Spine J"},{"key":"4688_CR34","doi-asserted-by":"publisher","first-page":"e235","DOI":"10.1016\/j.wneu.2018.06.166","volume":"118","author":"SL Zuckerman","year":"2018","unstructured":"Zuckerman SL, Lim J, Yamada Y, Bilsky MH, Laufer I (2018) Brachytherapy in Spinal Tumors: A Systematic Review. World Neurosurg 118:e235\u2013e244. https:\/\/doi.org\/10.1016\/j.wneu.2018.06.166","journal-title":"World Neurosurg"},{"key":"4688_CR35","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1097\/BRS.0b013e31819712ca","volume":"34","author":"S Demura","year":"2009","unstructured":"Demura S, Kawahara N, Murakami H, Nambu K, Kato S, Yoshioka K, Okayama T, Tomita K (2009) Surgical site infection in spinal metastasis: risk factors and countermeasures. Spine (Phila Pa 197) 34:635\u2013639. https:\/\/doi.org\/10.1097\/BRS.0b013e31819712ca","journal-title":"Spine (Phila Pa 197)"},{"key":"4688_CR36","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1097\/00007632-199803150-00015","volume":"23","author":"IB McPhee","year":"1998","unstructured":"McPhee IB, Williams RP, Swanson CE (1998) Factors influencing wound healing after surgery for metastatic disease of the spine. Spine (Phila Pa 1976) 23:726\u2013732. https:\/\/doi.org\/10.1097\/00007632-199803150-00015. discussion 732\u2013723","journal-title":"Spine (Phila Pa 1976)"},{"key":"4688_CR37","doi-asserted-by":"publisher","first-page":"S37","DOI":"10.1016\/j.spinee.2015.01.005","volume":"15","author":"NA Quraishi","year":"2015","unstructured":"Quraishi NA, Rajabian A, Spencer A, Arealis G, Mehdian H, Boszczyk BM, Edwards KL (2015) Reoperation rates in the surgical treatment of spinal metastases. Spine J 15:S37\u2013S43. https:\/\/doi.org\/10.1016\/j.spinee.2015.01.005","journal-title":"Spine J"},{"key":"4688_CR38","doi-asserted-by":"publisher","first-page":"663","DOI":"10.3171\/2017.10.SPINE1765","volume":"28","author":"HM Carl","year":"2018","unstructured":"Carl HM, Ahmed AK, Abu-Bonsrah N, De la Garza RR, Sankey EW, Pennington Z, Bydon A, Witham TF, Wolinsky JP, Gokaslan ZL, Sacks JM, Goodwin CR, Sciubba DM (2018) Risk factors for wound-related reoperations in patients with metastatic spine tumor. J Neurosurg Spine 28:663\u2013668. https:\/\/doi.org\/10.3171\/2017.10.SPINE1765","journal-title":"J Neurosurg Spine"}],"container-title":["Journal of Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-024-04688-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11060-024-04688-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-024-04688-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T14:05:33Z","timestamp":1718805933000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11060-024-04688-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,23]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["4688"],"URL":"https:\/\/doi.org\/10.1007\/s11060-024-04688-1","relation":{},"ISSN":["0167-594X","1573-7373"],"issn-type":[{"value":"0167-594X","type":"print"},{"value":"1573-7373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,23]]},"assertion":[{"value":"5 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"ES, KHK and PK received speaker honorary from ZEISS Meditec, Oberkochen.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}