Spinal metastases: Clinical scenarios

The goal of treatment in patients with spinal metastasis is palliation, that is, to improve the quality of remaining life as judged by alleviation of pain, preservation or restoration of neurology, and improvement in function. Local control of the spinal metastasis not only influences the overall survival of a cancer patient but is vital to maintain treatment benefits for the duration of the patient`s survival. However, cancer therapy––both surgical and nonsurgical––carries a significant risk of complications, morbidity, and even mortality. Decision-making regarding the most appropriate treatment strategy is vital when treating terminally ill patients with spinal metastatic disease.