{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:20:31Z","timestamp":1785554431079,"version":"3.56.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Spine metastases are very common in cancer patients often requiring urgent assessment and the initiation of therapy. Treatment paradigms have changed exponentially over the past decade with the evolution and integration of stereotactic body radiotherapy, minimally invasive spine techniques, and systemic options including biologics and checkpoint inhibitors. These advances necessitate multidisciplinary assessments and interventions to optimize outcomes. The NOMS framework provides a mechanism for all practitioners to evaluate the 4 sentinel assessments required to make decisions in patients with spine metastases: Neurologic, Oncologic, Mechanical Stability, and Systemic disease. The NOMS framework is continuously updated with the integration of newer technologies and evidence-based medicine as they become available. This paper presents the current iteration of NOMS with a focus on the role of medical and neuro-oncologists in the assessment and treatment of metastatic spine tumors.<\/jats:p>","DOI":"10.1093\/nop\/npaa056","type":"journal-article","created":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T04:20:20Z","timestamp":1607314820000},"page":"i25-i32","source":"Crossref","is-referenced-by-count":11,"title":["The importance of multidisciplinary care for spine metastases: initial tumor management"],"prefix":"10.1093","volume":"7","author":[{"given":"William Christopher","family":"Newman","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor University Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob L","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York Presbyterian\/Weill Cornell and Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6091-0709","authenticated-orcid":false,"given":"Mark H","family":"Bilsky","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,18]]},"reference":[{"key":"2020120621090601100_CIT0001","first-page":"335","article-title":"Prevalence of bone metastases and bone-targeting agent use among solid tumor patients in the United States","volume":"7","author":"Hernandez","year":"2015","journal-title":"Clin Epidemiol."},{"issue":"5","key":"2020120621090601100_CIT0002","doi-asserted-by":"crossref","first-page":"564","DOI":"10.3171\/spi.2005.2.5.0564","article-title":"Surgical management of spinal metastases: analysis of prognostic factors during a 10-year experience","volume":"2","author":"North","year":"2005","journal-title":"J Neurosurg Spine."},{"issue":"27","key":"2020120621090601100_CIT0003","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1056\/NEJM199212313272714","article-title":"Metastases and spinal cord compression","volume":"327","author":"Sinson","year":"1992","journal-title":"N Engl J Med."},{"issue":"1","key":"2020120621090601100_CIT0004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00007632-199001000-00001","article-title":"Spinal metastases: the obvious, the occult, and the impostors","volume":"15","author":"Wong","year":"1990","journal-title":"Spine (Phila Pa 1976)."},{"issue":"10185","key":"2020120621090601100_CIT0005","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1016\/S0140-6736(18)32487-5","article-title":"Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial","volume":"393","author":"Palma","year":"2019","journal-title":"Lancet."},{"issue":"21","key":"2020120621090601100_CIT0006","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1200\/JCO.2017.72.7362","article-title":"Integrating evidence-based medicine for treatment of spinal metastases into a decision framework: neurologic, oncologic, mechanicals stability, and systemic disease","volume":"35","author":"Barzilai","year":"2017","journal-title":"J Clin Oncol."},{"issue":"6","key":"2020120621090601100_CIT0007","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1634\/theoncologist.4-6-459","article-title":"The diagnosis and treatment of metastatic spinal tumor","volume":"4","author":"Bilsky","year":"1999","journal-title":"Oncologist."},{"issue":"10","key":"2020120621090601100_CIT0008","doi-asserted-by":"crossref","first-page":"2434","DOI":"10.1016\/j.spinee.2014.03.006","article-title":"Improvement in pain after lumbar surgery in cancer patients with mechanical radiculopathy","volume":"14","author":"Moliterno","year":"2014","journal-title":"Spine J."},{"issue":"3","key":"2020120621090601100_CIT0009","doi-asserted-by":"crossref","first-page":"324","DOI":"10.3171\/2010.3.SPINE09459","article-title":"Reliability analysis of the epidural spinal cord compression scale","volume":"13","author":"Bilsky","year":"2010","journal-title":"J Neurosurg Spine."},{"issue":"7","key":"2020120621090601100_CIT0010","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/S0009-9260(98)80168-2","article-title":"T1-weighted magnetic resonance imaging in breast cancer vertebral metastases: changes on treatment and correlation with response to therapy","volume":"53","author":"Brown","year":"1998","journal-title":"Clin Radiol."},{"issue":"22","key":"2020120621090601100_CIT0011","doi-asserted-by":"crossref","first-page":"E1418","DOI":"10.1097\/BRS.0b013e3182a40838","article-title":"Measurement of blood perfusion in spinal metastases with dynamic contrast-enhanced magnetic resonance imaging: evaluation of tumor response to radiation therapy","volume":"38","author":"Chu","year":"2013","journal-title":"Spine (Phila Pa 1976)."},{"issue":"1","key":"2020120621090601100_CIT0012","doi-asserted-by":"crossref","first-page":"E9","DOI":"10.3171\/2016.9.FOCUS16378","article-title":"Dynamic contrast-enhanced magnetic resonance imaging of osseous spine metastasis before and 1 hour after high-dose image-guided radiation therapy","volume":"42","author":"Lis","year":"2017","journal-title":"Neurosurg Focus."},{"issue":"22","key":"2020120621090601100_CIT0013","doi-asserted-by":"crossref","first-page":"3072","DOI":"10.1200\/JCO.2010.34.3897","article-title":"Spinal Instability Neoplastic Score: an analysis of reliability and validity from the Spine Oncology Study Group","volume":"29","author":"Fourney","year":"2011","journal-title":"J Clin Oncol."},{"issue":"6","key":"2020120621090601100_CIT0014","doi-asserted-by":"crossref","first-page":"744\u2013751","DOI":"10.1634\/theoncologist.2012-0293","article-title":"The NOMS framework: approach to the treatment of spinal metastatic tumors","volume":"18","author":"Laufer","year":"2013","journal-title":"Oncologist."},{"issue":"22 suppl","key":"2020120621090601100_CIT0015","doi-asserted-by":"crossref","first-page":"S78","DOI":"10.1097\/BRS.0b013e3181b8b6f5","article-title":"Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes?","volume":"34","author":"Gerszten","year":"2009","journal-title":"Spine (Phila Pa 1976)."},{"issue":"4","key":"2020120621090601100_CIT0016","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/0360-3016(95)00572-G","article-title":"Effectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial","volume":"32","author":"Maranzano","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys."},{"issue":"1","key":"2020120621090601100_CIT0017","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.ijrobp.2009.10.056","article-title":"Radiotherapy for patients with metastases to the spinal column: a review of 603 patients at Shizuoka Cancer Center Hospital","volume":"79","author":"Mizumoto","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys."},{"issue":"1","key":"2020120621090601100_CIT0018","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2016.9.FOCUS16369","article-title":"The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery","volume":"42","author":"Yamada","year":"2017","journal-title":"Neurosurg Focus."},{"issue":"19","key":"2020120621090601100_CIT0019","doi-asserted-by":"crossref","first-page":"4566","DOI":"10.1002\/cncr.26067","article-title":"A survey of stereotactic body radiotherapy use in the United States","volume":"117","author":"Pan","year":"2011","journal-title":"Cancer."},{"issue":"4","key":"2020120621090601100_CIT0020","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1016\/j.ijrobp.2009.10.003","article-title":"Correlation of local failure with measures of dose insufficiency in the high-dose single-fraction treatment of bony metastases","volume":"77","author":"Lovelock","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys."},{"issue":"1","key":"2020120621090601100_CIT0021","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.radonc.2014.02.010","article-title":"Axitinib sensitization of high single dose radiotherapy","volume":"111","author":"Rao","year":"2014","journal-title":"Radiother Oncol."},{"issue":"9486","key":"2020120621090601100_CIT0022","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0140-6736(05)66954-1","article-title":"Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial","volume":"366","author":"Patchell","year":"2005","journal-title":"Lancet."},{"key":"2020120621090601100_CIT0023","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1097\/BRS.0b013e3181bac4b2","article-title":"Shifting paradigms in the treatment of metastatic spine disease","volume":"34","author":"Bilsky","year":"2009","journal-title":"Spine (Phila Pa 1976)."},{"issue":"9","key":"2020120621090601100_CIT0024","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1007\/s007010050199","article-title":"Surgical results for spinal metastases","volume":"140","author":"Klekamp","year":"1998","journal-title":"Acta Neurochir (Wien)."},{"issue":"3","key":"2020120621090601100_CIT0025","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3171\/2012.11.SPINE12111","article-title":"Local disease control for spinal metastases following \u201cseparation surgery\u201d and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients","volume":"18","author":"Laufer","year":"2013","journal-title":"J Neurosurg Spine."},{"issue":"3","key":"2020120621090601100_CIT0026","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S1470-2045(11)70008-0","article-title":"Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial","volume":"12","author":"Berenson","year":"2011","journal-title":"Lancet Oncol."},{"issue":"5","key":"2020120621090601100_CIT0027","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1093\/ons\/opy186","article-title":"Utility of cement augmentation via percutaneous fenestrated pedicle screws for stabilization of cancer-related spinal instability","volume":"16","author":"Barzilai","year":"2019","journal-title":"Oper Neurosurg (Hagerstown)."},{"issue":"3","key":"2020120621090601100_CIT0028","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/00007632-200102010-00016","article-title":"Surgical strategy for spinal metastases","volume":"26","author":"Tomita","year":"2001","journal-title":"Spine (Phila Pa 1976)."},{"issue":"19","key":"2020120621090601100_CIT0029","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1097\/01.brs.0000180401.06919.a5","article-title":"A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis","volume":"30","author":"Tokuhashi","year":"2005","journal-title":"Spine (Phila Pa 1976)."},{"issue":"8","key":"2020120621090601100_CIT0030","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1002\/jso.24620","article-title":"The SORG nomogram accurately predicts 3- and 12-months survival for operable spine metastatic disease: external validation","volume":"115","author":"Paulino Pereira","year":"2017","journal-title":"J Surg Oncol."},{"issue":"10","key":"2020120621090601100_CIT0031","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1016\/j.spinee.2018.03.011","article-title":"Predicting survival for metastatic spine disease: a comparison of nine scoring systems","volume":"18","author":"Ahmed","year":"2018","journal-title":"Spine J."},{"issue":"10","key":"2020120621090601100_CIT0032","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1056\/NEJMoa1112824","article-title":"Immunologic correlates of the abscopal effect in a patient with melanoma","volume":"366","author":"Postow","year":"2012","journal-title":"N Engl J Med."},{"issue":"10","key":"2020120621090601100_CIT0033","first-page":"e5844","article-title":"Trends in the abscopal effect after radiation to spinal metastases: a systematic review","volume":"11","author":"Macki","year":"2019","journal-title":"Cureus."}],"container-title":["Neuro-Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/nop\/article-pdf\/7\/Supplement_1\/i25\/34372234\/npaa056.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/nop\/article-pdf\/7\/Supplement_1\/i25\/34372234\/npaa056.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T04:20:30Z","timestamp":1607314830000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/nop\/article\/7\/Supplement_1\/i25\/5987750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":33,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2020,11,18]]},"published-print":{"date-parts":[[2020,11,18]]}},"URL":"https:\/\/doi.org\/10.1093\/nop\/npaa056","relation":{},"ISSN":["2054-2577","2054-2585"],"issn-type":[{"value":"2054-2577","type":"print"},{"value":"2054-2585","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11]]},"published":{"date-parts":[[2020,11]]}}}