Thoraco lumbar spine metastasis Current concepts and an update on surgical management

Spinal metastases are causing a treatment dilemma worldwide. As current medicine evolves, treatment of primary tumours is improving, leading to increased survival and hence later presentation of metastases. Spine is one of the main locations for metastases with thoracolumbar regions being most commonly affected. Currently treatment options are mainly for palliation and include chemotherapy, radiotherapy and surgery. A review of literature was carried to look into the current practices and evidence for the management of thoracolumbar spinal metastases. As surgical techniques are becoming more minimally invasive, a similar trend is occuring in treatment of metastatic disease. This is resulting in fewer morbidities and complications, which has a knock-on effect of increasing survival in certain patient groups. However, there are still concerns regarding the appropriate surgical approaches for thoracolumbar metastases and whether these newer minimally invasive techniques have the same oncological benefits as the standard open procedures. Future research should focus on comparing outcomes and survival rate of minimally invasive versus open surgery.