{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T12:33:54Z","timestamp":1790944434478,"version":"4.1.0"},"reference-count":102,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>The treatment for spinal metastasis has evolved significantly during the past decade. An advancement in systemic therapy has led to a prolonged overall survival in cancer patients, thus increasing the incidence of spinal metastasis. In addition, with the improved treatment armamentarium, the prediction of patient survival using traditional prognostic models may have limitations and these require the incorporation of some novel parameters to improve their prognostic accuracy. The development of minimally-invasive spinal procedures and minimal access surgical techniques have facilitated a quicker patient recovery and return to systemic treatment. These modern interventions help to alleviate pain and improve quality of life, even in candidates with a relatively short life expectancy. Radiotherapy may be considered in non-surgical candidates or as adjuvant therapy for improving local tumour control. Stereotactic radiosurgery has facilitated this even in radioresistant tumours and may even replace surgery in radiosensitive malignancies. This narrative review summarizes the current evidence leading to the paradigm shifts in the modern treatment of spinal metastasis.<\/jats:p>","DOI":"10.1177\/03000605221091665","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T01:42:27Z","timestamp":1650332547000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":53,"title":["Spinal metastasis: narrative reviews of the current evidence and treatment modalities"],"prefix":"10.1177","volume":"50","author":[{"given":"Pilan","family":"Jaipanya","sequence":"first","affiliation":[{"name":"Chakri Naruebodindra Medical Institute, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand"},{"name":"Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7496-2670","authenticated-orcid":false,"given":"Pongsthorn","family":"Chanplakorn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Metastatic Spinal Cord Compression: Diagnosis and Management of Patients at Risk of or with Metastatic Spinal Cord Compression. Cardiff (UK): National Collaborating Centre for Cancer (UK); 2008 Nov. PMID: 22171401."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2004.04.018"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0171507"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/not318"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27849"},{"key":"e_1_3_2_7_2","first-page":"107969","article-title":"Physiopathology of spine metastasis.","volume":"2011","author":"Maccauro G","year":"2011","unstructured":"Maccauro G, Spinelli MS, Mauro S, et\u00a0al. Physiopathology of spine metastasis. Int J Surg Oncol 2011; 2011: 107969.","journal-title":"Int J Surg Oncol"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2016.03.026"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-018-0079-0"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.11058"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000667"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1098\/rsob.180037"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012-0293"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.723943"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001811"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2021.0395.r2"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01402610"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(99)00333-8"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1983.59.1.0111"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.11.2.2028061"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s003300050549"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2007.11.039"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0730-725X(00)00181-8"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.3171\/2010.3.SPINE09459"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.08.028"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001827"},{"key":"e_1_3_2_27_2","first-page":"2191","article-title":"Comparison of radionuclide bone scans and magnetic resonance imaging in detecting spinal metastases","volume":"34","author":"Gosfield E","year":"1993","unstructured":"Gosfield E3rd, Alavi A, Kneeland B. Comparison of radionuclide bone scans and magnetic resonance imaging in detecting spinal metastases. J Nucl Med 1993; 34: 2191\u20132198.","journal-title":"J Nucl Med"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.2.170006"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000528"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(05)80011-5"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.9.1360"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.9.1255"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00172664"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.3.348"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu103"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2013.05.001"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19425"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.6316"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu519"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.29.7101"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2012.08.002"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219884069"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1867-6"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.9338"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20633"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.10.073"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.01.65"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217697691"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.34.3897"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181e16ae2"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1053\/clon.2001.9256"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-008-0763-1"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7408.195"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000180401.06919.a5"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200102010-00016"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.3171\/2020.12.SPINE201741"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24620"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-021-06954-6"},{"key":"e_1_3_2_59_2","article-title":"Overall Survival with Osimertinib in Untreated, EGFR-Mutated Advanced NSCLC.","author":"Ramalingam SS","unstructured":"Ramalingam SS, Vansteenkiste J, Planchard D, et\u00a0al. Overall Survival with Osimertinib in Untreated, EGFR-Mutated Advanced NSCLC. N Engl J Med 202; 382: 41\u201350.","journal-title":"N Engl J Med"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-018-0810-4"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2017.43"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.2174\/1871520616666160502122724"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-004-0870-6"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13840"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2013.06.013"},{"key":"e_1_3_2_66_2","unstructured":"Majeed H Gupta V. Adverse Effects Of Radiation Therapy. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright\u00a9 2021 StatPearls Publishing LLC; 2021."},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-014-0717-z"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.05.012"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2003.10.006"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.754"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.04.044"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2015.11.002"},{"key":"e_1_3_2_73_2","doi-asserted-by":"publisher","DOI":"10.1177\/1533033820945798"},{"key":"e_1_3_2_74_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx567"},{"key":"e_1_3_2_75_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.09.007"},{"key":"e_1_3_2_76_2","doi-asserted-by":"publisher","DOI":"10.3171\/2013.12.SPINE12811"},{"key":"e_1_3_2_77_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2018.00626"},{"key":"e_1_3_2_78_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-021-01431-9"},{"key":"e_1_3_2_79_2","first-page":"533","article-title":"Timing of surgery and radiotherapy in the management of metastatic spine disease: a systematic review","volume":"36","author":"Itshayek E","year":"2010","unstructured":"Itshayek E, Yamada J, Bilsky M, et\u00a0al. Timing of surgery and radiotherapy in the management of metastatic spine disease: a systematic review. Int J Oncol 2010; 36: 533\u2013544.","journal-title":"Int J Oncol"},{"key":"e_1_3_2_80_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219889363"},{"key":"e_1_3_2_81_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-020-01740-y"},{"key":"e_1_3_2_82_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.06.062"},{"key":"e_1_3_2_83_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181b77895"},{"key":"e_1_3_2_84_2","doi-asserted-by":"publisher","DOI":"10.1177\/107327481402100208"},{"key":"e_1_3_2_85_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.08.026"},{"key":"e_1_3_2_86_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2010.09.011"},{"key":"e_1_3_2_87_2","first-page":"570","article-title":"Osteoblastic and mixed spinal metastases: evaluation of the analgesic efficacy of percutaneous vertebroplasty","volume":"28","author":"Calmels V","year":"2007","unstructured":"Calmels V, Vall\u00e9e JN, Rose M, et\u00a0al. Osteoblastic and mixed spinal metastases: evaluation of the analgesic efficacy of percutaneous vertebroplasty. AJNR Am J Neuroradiol 2007; 28: 570\u2013574.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_88_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2009.04.007"},{"key":"e_1_3_2_89_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis.2010.002675"},{"key":"e_1_3_2_90_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.07.110"},{"key":"e_1_3_2_91_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.01.124"},{"key":"e_1_3_2_92_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04799-0"},{"key":"e_1_3_2_93_2","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S332985"},{"key":"e_1_3_2_94_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.10.175"},{"key":"e_1_3_2_95_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-015-0468-y"},{"key":"e_1_3_2_96_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200110000-00006"},{"key":"e_1_3_2_97_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.10.086"},{"key":"e_1_3_2_98_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2018.05.037"},{"key":"e_1_3_2_99_2","doi-asserted-by":"publisher","DOI":"10.3171\/2020.8.SPINE201166"},{"key":"e_1_3_2_100_2","first-page":"1","article-title":"Outcome analysis of surgery for symptomatic spinal metastases in long-term cancer survivors","author":"Barzilai O","year":"2019","unstructured":"Barzilai O, McLaughlin L, Lis E, et\u00a0al. Outcome analysis of surgery for symptomatic spinal metastases in long-term cancer survivors. J Neurosurg Spine 2019: 1\u20136.","journal-title":"J Neurosurg Spine"},{"key":"e_1_3_2_101_2","doi-asserted-by":"publisher","DOI":"10.3171\/2021.2.FOCUS201121"},{"key":"e_1_3_2_102_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-12-33"},{"key":"e_1_3_2_103_2","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2016.0909.003"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605221091665","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605221091665","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605221091665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:50:15Z","timestamp":1777459815000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605221091665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":102,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1177\/03000605221091665"],"URL":"https:\/\/doi.org\/10.1177\/03000605221091665","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]},"article-number":"03000605221091665"}}