Surgical Approach to Bone Metastases

Curr Osteoporos Rep. 2018 Aug;16(4):512-518. doi: 10.1007/s11914-018-0463-7.

Abstract

Purpose of review: The purpose of this review was to examine the recent changes in the surgical treatment of bone metastases and how the treatment paradigm has shifted with the improvement of adjuvant therapies. How surgery fits into the local and systemic treatment was reviewed for bone metastases in different areas.

Recent findings: The more common use of targeted chemotherapies and focused high-dose radiation have altered the treatment paradigm of bone metastases. Overall changes in the surgical treatment of bone metastases have been driven by an increased multidisciplinary approach to metastatic cancer and the awareness that one type of surgery does not work for all patients. The individual patient treatment goals dictate the surgical procedures used to achieve these goals. Advancements in adjuvant therapy-like radiation and more targeted chemotherapies have allowed for less invasive surgical approaches and therefore faster recoveries and reduced surgical morbidity for patients.

Keywords: Bone metastases; Cancer; Pain; Spinal metastases; Surgery.

Publication types

  • Review

MeSH terms

  • Amputation, Surgical*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Bone Cements
  • Bone Neoplasms / complications
  • Bone Neoplasms / secondary
  • Bone Neoplasms / surgery*
  • Cancer Pain / etiology
  • Chemotherapy, Adjuvant
  • Decompression, Surgical*
  • Fracture Fixation, Internal
  • Fracture Fixation, Intramedullary
  • Fractures, Spontaneous / etiology
  • Fractures, Spontaneous / surgery
  • Humans
  • Metastasectomy*
  • Open Fracture Reduction
  • Orthopedic Procedures*
  • Patient Care Planning
  • Pedicle Screws
  • Prostheses and Implants
  • Prosthesis Implantation*
  • Radiosurgery
  • Radiotherapy, Adjuvant
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / surgery

Substances

  • Antineoplastic Agents, Immunological
  • Bone Cements