[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-435537-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-435537-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","contemporary-management-strategies-for-spinal-metastases-diagnosis-multidisciplinary-approaches-and-outcomes-a-narrative-review","Contemporary management strategies for spinal metastases - diagnosis, multidisciplinary approaches, and outcomes - a narrative review","","Spinal metastases affect roughly 30%–70% of cancer patients, with 10%–20% developing symptomatic pain, instability, or neurological deficits, and about 20% presenting with malignant spinal cord compression as the first malignancy sign. This narrative review, guided by SANRA and based on PubMed, EMBASE, and Cochrane evidence from 2000–2025, synthesizes diagnostic imaging, NOMS decision frameworks, and multidisciplinary treatment strategies. It highlights thoracic predominance, common primary tumors, MRI advantages, and evolving surgery toward decompression with stabilization, emphasizing early recognition for improved functional and quality-of-life outcomes.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/contemporary-management-strategies-for-spinal-metastases-diagnosis-multidisciplinary-approaches-and-outcomes-a-narrative-review/435537/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/contemporary-management-strategies-for-spinal-metastases-diagnosis-multidisciplinary-approaches-and-outcomes-a-narrative-review/435537.png","ImageObject",300,407,{"name":42,"@type":43},"kopisore","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the clinical significance of metastatic spinal cord compression in spinal metastases?","Question",{"text":63,"@type":64},"Metastatic spinal cord compression can be the initial malignancy manifestation in about 20% of cases. This underscores the urgency of early detection to prevent irreversible neurological deficits.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which spinal regions are most commonly affected by metastases?",{"text":68,"@type":64},"Metastases most commonly involve the thoracic region, followed by lumbar and cervical regions. 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Nearly 20% of patients present with malignant spinal cord compression as their initial manifestation of malignancy. Our objectives were to provide a comprehensive review of contemporary management strategies for spinal metastases, focusing on diagnostic approaches, multidisciplinary treatment frameworks, and surgical interventions that optimize patient functional outcomes and quality of life.  \nMethods: SANRA-guided narrative review of PubMed, EMBASE, and Cochrane Library (2000-2025) . Clinical trials, metaanalyses, consensus statements, and seminal papers were prioritized; purposive selection ensured broad thematic coverage. The analysis encompasses imaging techniques, surgical interventions, and decision-making frameworks including the NOMS (Neurologic, Oncologic, Mechanical, and Systemic) classification system.  \nResults: Within the spinal column, metastases most commonly affect the thoracic region, followed by lumbar and cervical regions. Common primary tumors with high bone metastasis rates include breast (72%), prostate (84%), thyroid (50%), lung (31%), kidney (37%), and pancreas (33%), collectively accounting for more than 80% of spinal metastases cases. Magnetic resonance imaging demonstrates the advantage of detecting multilevel involvement without radiation exposure. Contemporary management employs a multidisciplinary approach incorporating chemotherapy, radiotherapy, and surgical interventions. Modern surgical approaches have evolved from historical laminectomy-only procedures to comprehensive decompression with stabilization techniques. Conclusions: Early recognition and prompt intervention remain critical for preventing irreversible neurological deficits and optimizing patient outcomes. Future improvements in molecular targeted therapies, imaging precision, and surgical techniques promise continued enhancement of treatment outcomes for patients with spinal metastases.  \nKeywords: metastatic spinal cord compression, minimally invasive surgery, NOMS framework, radiotherapy (SBRT/SRS), spinal metastases  \nIntroduction  \nSpinal metastases occur in 30–70% of cancer patients, with 10– 20% developing symptomatic complications such as pain, instability, or neurological deficits[1,2] . As cancer survivorship improves, the incidence of spinal metastases is rising, necessitating refined strategies for timely diagnosis and intervention.  \naDepartment of Neurosurgery, AIIMS Jammu, Jammu, India, bDepartment of  \nNeurosurgery, Fortis Hospital, Shalimar bagh, Jammu, India, cDepartment of Oncoanesthesia and Palliative Care, All India Institute of Medical Sciences, Bhopal, Jammu, India, dEpidemiology and Public Health SKUAST Jammu, Jammu, India and eDepartment of Neurosurgery, College of Medical Sciences, Bharatpur, Nepal Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: Department of Neurosurgery, College ofMedical Sciences,Bharatpur 44200, Nepal. Tel.: +[9779845454636. E-mail: trozexa@gmail.com](9779845454636. E-mail: trozexa@gmail.com)[ ](9779845454636. E-mail: trozexa@gmail.com)(B. Chaurasia).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons AttributionNon Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permis","cbCaiumBQF0eHGhX","https://ap.wps.com/l/cbCaiumBQF0eHGhX","pdf",446943,"English","# Introduction\n## Spinal metastases burden and need for timely intervention\n# Methods\n## SANRA-guided narrative review and evidence sources\n## NOMS-based decision-making framework\n# Results\n## Anatomical distribution and common primary tumors\n## Imaging and multidisciplinary management\n## Surgical evolution toward decompression with stabilization\n# Conclusions\n## Early recognition and future improvements","[{\"question\":\"What is the clinical significance of metastatic spinal cord compression in spinal metastases?\",\"answer\":\"Metastatic spinal cord compression can be the initial malignancy manifestation in about 20% of cases. This underscores the urgency of early detection to prevent irreversible neurological deficits.\"},{\"question\":\"Which spinal regions are most commonly affected by metastases?\",\"answer\":\"Metastases most commonly involve the thoracic region, followed by lumbar and cervical regions. The thoracic spine accounts for the majority of cases.\"},{\"question\":\"How does the review structure decision-making and treatment planning?\",\"answer\":\"The review integrates imaging and multidisciplinary treatment approaches within the NOMS (Neurologic, Oncologic, Mechanical, and Systemic) framework, combining chemotherapy, radiotherapy, and evolving surgical strategies to optimize functional outcomes.\"}]","Contemporary management strategies for spinal metastases - diagnosis, multidisciplinary approaches, and outcomes - a narrative review | PDF",1790674010,15]