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AO Spine Clinical Practice Recommendations: Reducing the Surgical Footprint of Surgery for Spinal Metastases

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dc.contributor.authorSilva, Alvaro
dc.contributor.authorChen, Hanbo
dc.contributor.authorDisch, Alexander
dc.contributor.authorKam, Jeremy
dc.contributor.authorO'Toole, John
dc.contributor.authorDea, Nicolas
dc.contributor.authorGasbarrini, Alessandro
dc.contributor.authorLaufer, Ilya
dc.contributor.authorNetzer, Cordula
dc.contributor.authorReynolds, Jeremy
dc.contributor.authorD Rhines, Laurence
dc.contributor.authorSahgal, Arjun
dc.contributor.authorVerlaan, Jorrit-Jan
dc.contributor.authorFisher, Charles
dc.contributor.authorBarzilai, Ori
dc.date.accessioned2026-09-25T13:21:33Z
dc.date.available2026-09-25T13:21:33Z
dc.date.issued2026
dc.description.abstractStudy DesignLiterature review with clinical recommendations.ObjectiveSpinal metastases represent a late complication of cancer and a major factor in decreased quality of life. The role of surgery for specific indications for spinal metastases is well established. Given the significant morbidity associated with spine surgery in this frail population, efforts are ongoing to decrease the surgical footprint. The objective of this study is to provide the readers with a concise curation of the latest spine literature on reducing the surgical footprint for spine metastases and clinical recommendations for how the practicing clinician should interpret and make use of this evidence.MethodsThe latest spine literature in the topic of reducing the surgical footprint for spine metastases was reviewed and clinical recommendations were formulated. The recommendations are dichotomously graded into strong and conditional based on the integration of scientific methodology and content expert opinion. This opinion considers experience and practical issues such as risks, burdens, costs, patient values, and circumstances.ResultsFour high impact studies were selected for review. The findings suggest that surgery plays a key role in improving patients' quality of life, but incidence of adverse events remains high and hence methods to decrease surgical morbidity are necessary. The integration of radiation into the treatment algorithm allows for less extensive surgical procedures and SBRT should be strongly considered after surgery for spine metastases in appropriate patient populations. Implementation of enhanced recovery after surgery (ERAS) protocols reduce perioperative morbidity for both open and minimally invasive surgeries and should be considered on an institutional level. Utilization of minimally invasive surgical stabilization should be considered as it results in fewer post operative complications, lower infection rates, less blood loss during surgery, and a shorter hospital stay compared to open stabilization of unstable pathology thoracolumbar fractures.ConclusionsThe role and benefits of surgery for metastatic spine disease are well established, yet surgery carries significant risk for adverse events which may negatively affect overall cancer care. Methods for reducing the surgical footprint include incorporation of stereotactic radiation allowing less extensive surgery, implementation of ERAS protocols and utilization of minimally invasive surgical strategies.
dc.description.versionVersión Publicada
dc.identifier.citationSilva González, A., Chen, H., Disch, A. C., Kam, J., O'Toole, J. E., Dea, N., Gasbarrini, A., Laufer, I., Netzer, C., Reynolds, J., Rhines, L. D., Sahgal, A., Verlaan, J. J., Fisher, C. G., & Barzilai, O. (2026). AO Spine Clinical Practice Recommendations: Reducing the Surgical Footprint of Surgery for Spinal Metastases. Global spine journal, 16(1), 11–18. https://doi.org/10.1177/21925682251352442
dc.identifier.doihttps://doi.org/10.1177/21925682251352442
dc.identifier.urihttps://hdl.handle.net/11447/11185
dc.language.isoen
dc.subjectEnhanced recovery after surgery
dc.subjectFrail
dc.subjectMinimally invasive spine surgery
dc.subjectRadiosurgery
dc.subjectSpinal metases
dc.titleAO Spine Clinical Practice Recommendations: Reducing the Surgical Footprint of Surgery for Spinal Metastases
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceGlobal spine journal
dspace.entity.typePublication
relation.isAuthorOfPublicationa2b04bb7-0a8f-4c0d-9062-1f545c410c9c
relation.isAuthorOfPublication.latestForDiscoverya2b04bb7-0a8f-4c0d-9062-1f545c410c9c

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