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Management of Metastases to the Spine and Sacrum

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Management of Bone Metastases

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Abstract

The incidence of bone metastatic deposit from carcinoma is second only to pulmonary and hepatic metastases. The most frequently affected segment of the skeleton is the vertebral column. Refinement of the protocols for treating tumour patients has led to a progressive improvement in the prognosis for many tumour histotypes in terms of increase of life expectancy. The choice of the most appropriate treatment is of crucial importance for the patient who may be severely disabled by the presence of untreated spinal metastases. It is commonly accepted that bone metastases are an expression of a systemic disease, and therefore require multi-disciplinary treatment, integrating radiotherapy (RT), chemotherapy (CHT) and surgery. The most appropriate treatment for patients with metastatic disease of the vertebral column is controversial. Appropriate surgical treatment of bone metastases and tumours in general has now become an integral part of the correct approach to the tumour patient. The evolution of anaesthetic techniques now allows more aggressive treatment of some patients with spinal and sacral metastases. These procedures can dramatically improve the patient’s quality of life and may prolong the patient’s life expectancy by preventing complications related to paralysis.

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Acknowledgements

The authors thank Mr. Carlo Piovani for his helpful collaboration in patients’ images storage and editing.

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Authors and Affiliations

  1. Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Riccardo Ghermandi, Gisberto Evangelisti, Marco Girolami, Valerio Pipola, Stefano Bandiera, Giovanni Barbanti-Bròdano, Cristiana Griffoni, Giuseppe Tedesco, Silvia Terzi & Alessandro Gasbarrini

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  1. Riccardo Ghermandi
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  2. Gisberto Evangelisti
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  3. Marco Girolami
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  6. Giovanni Barbanti-Bròdano
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Correspondence to Alessandro Gasbarrini .

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Editors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy

    Vincenzo Denaro

  2. Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy

    Alberto Di Martino

  3. General Direction of Health Program, National Ministry of Health of Italy, Rome, Italy

    Andrea Piccioli

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Ghermandi, R. et al. (2019). Management of Metastases to the Spine and Sacrum. In: Denaro, V., Di Martino, A., Piccioli, A. (eds) Management of Bone Metastases. Springer, Cham. https://doi.org/10.1007/978-3-319-73485-9_8

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