{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T16:39:55Z","timestamp":1793378395382,"version":"4.5.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Narrative review of contemporary literature alongside institutional experience applying the NOMS framework to cervical spine tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To supplement the NOMS framework with cervical spine\u2013specific considerations: summary of background data.<\/jats:p>\n                    <jats:p>The NOMS framework provides a widely applicable approach to spinal oncology based on neurological, oncologic, mechanical, and systemic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Contemporary literature and published institutional experience addressing cervical spine tumors were reviewed<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Cervical spine tumors require region-specific modification of conventional NOMS decision-making. Mechanical considerations are particularly important at the occipitocervical and cervicothoracic junctions, where tumor-related or iatrogenic instability may necessitate extended constructs and careful fixation strategies.<\/jats:p>\n                    <jats:p>Systemic factors, including frailty, malnutrition, prior radiation, active therapy, and prognosis, remain critical determinants of surgical candidacy. Complex cases may require multidisciplinary planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>NOMS remains a useful foundation for cervical spine oncology but should be supplemented by region-specific anatomic and biomechanical considerations.<\/jats:p>\n                    <jats:p>Treatment should be individualized according to neurological compromise, tumor biology, mechanical stability, systemic disease, and surgical morbidity. 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