Spinal Metastatic Disease: A Review of the Role of the Multidisciplinary Team
Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We p...
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Published in | Orthopaedic surgery Vol. 9; no. 2; pp. 145 - 151 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Melbourne
John Wiley & Sons Australia, Ltd
01.05.2017
John Wiley & Sons, Inc |
Subjects | |
Online Access | Get full text |
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Abstract | Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. The wide variation in clinical presentation and tumor response to treatment necessitates a multidisciplinary approach that integrates the diagnosis and treatment of the cancer, symptom management, and rehabilitation for optimal care of patients with spinal metastases. Advances in the field of radiology have led to earlier and more focused diagnosis of spinal metastasis and acts to guide therapy. Advances in surgical techniques, neurophysiologic monitoring, and anesthetic expertise have allowed surgeons to perform more extensive procedures leading to improved outcomes and reduced morbidity. Radiation oncology input that is essential as external beam radiation therapy can provide significant pain relief. Non‐operative measures may include bisphosphonate infusions, management of complications (e.g. hypercalcemia of malignancy), monoclonal antibody infusions, and chemotherapy if indicated in the treatment of the primary malignancy. Input from psychology services is necessary to address the biopsychosocial ramifications of spinal metastasis. Allied health professionals in the form of physiotherapists, social workers, and dieticians also contribute in maximizing patients’ quality of life and well‐being. |
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AbstractList | Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. The wide variation in clinical presentation and tumor response to treatment necessitates a multidisciplinary approach that integrates the diagnosis and treatment of the cancer, symptom management, and rehabilitation for optimal care of patients with spinal metastases. Advances in the field of radiology have led to earlier and more focused diagnosis of spinal metastasis and acts to guide therapy. Advances in surgical techniques, neurophysiologic monitoring, and anesthetic expertise have allowed surgeons to perform more extensive procedures leading to improved outcomes and reduced morbidity. Radiation oncology input that is essential as external beam radiation therapy can provide significant pain relief. Non‐operative measures may include bisphosphonate infusions, management of complications (e.g. hypercalcemia of malignancy), monoclonal antibody infusions, and chemotherapy if indicated in the treatment of the primary malignancy. Input from psychology services is necessary to address the biopsychosocial ramifications of spinal metastasis. Allied health professionals in the form of physiotherapists, social workers, and dieticians also contribute in maximizing patients’ quality of life and well‐being. |
Author | Piggott, Robert P Munigangaiah, Sudarshan McCabe, John P Baker, Joseph F Devitt, Aiden Curtin, Mark Murphy, Evelyn P |
AuthorAffiliation | 1 Department of Trauma and Orthopaedic Surgery University College Hospital Galway, Saolta Hospital Group Galway Ireland |
AuthorAffiliation_xml | – name: 1 Department of Trauma and Orthopaedic Surgery University College Hospital Galway, Saolta Hospital Group Galway Ireland |
Author_xml | – sequence: 1 givenname: Mark surname: Curtin fullname: Curtin, Mark email: markcurtin10@gmail.com organization: University College Hospital Galway, Saolta Hospital Group – sequence: 2 givenname: Robert P surname: Piggott fullname: Piggott, Robert P organization: University College Hospital Galway, Saolta Hospital Group – sequence: 3 givenname: Evelyn P surname: Murphy fullname: Murphy, Evelyn P organization: University College Hospital Galway, Saolta Hospital Group – sequence: 4 givenname: Sudarshan surname: Munigangaiah fullname: Munigangaiah, Sudarshan organization: University College Hospital Galway, Saolta Hospital Group – sequence: 5 givenname: Joseph F surname: Baker fullname: Baker, Joseph F organization: University College Hospital Galway, Saolta Hospital Group – sequence: 6 givenname: John P surname: McCabe fullname: McCabe, John P organization: University College Hospital Galway, Saolta Hospital Group – sequence: 7 givenname: Aiden surname: Devitt fullname: Devitt, Aiden organization: University College Hospital Galway, Saolta Hospital Group |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28544780$$D View this record in MEDLINE/PubMed |
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Keywords | Oncology Diagnosis Metastasis Spine Multidisciplinary |
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SubjectTerms | Antineoplastic Agents - therapeutic use Diagnosis Humans Medical diagnosis Mental Health Services - statistics & numerical data Metastasis Multidisciplinary Nutritional Support Oncology Palliative Care - methods Patient Care Team - organization & administration Physical Therapy Modalities Review Spinal Neoplasms - diagnosis Spinal Neoplasms - secondary Spinal Neoplasms - therapy Spine Well being |
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