92. Concepts and Surgical Treatment of Metastatic Bone Disease

  1. Clifford J. Rosen MD
  1. Kristy Weber and
  2. Scott L. Kominsky

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch92

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Weber, K. and Kominsky, S. L. (2013) Concepts and Surgical Treatment of Metastatic Bone Disease, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch92

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • bisphosphonate therapy;
  • kyphoplasty;
  • metastatic bone disease;
  • metastatic bone lesions;
  • surgical treatment;
  • tumor-bone interactions;
  • vertebroplasty

Summary

This chapter focuses on treatment that affects the neoplastic process as well as the bone microenvironment. It discusses the molecular events related to metastatic bone disease. The chapter summarizes the use of bisphosphonate therapy as well as surgical stabilization. Upon arrival in bone, tumor cells begin a reciprocal (bilateral) interaction with the bone microenvironment. This interaction fosters tumor growth while offsetting the normally balanced process of bone remodeling toward either net bone destruction or formation, causing significant morbidity. The most common site of bone metastasis is the thoracic spine. If patients are neurologically intact and there are no fracture fragments impinging on the spinal cord, radiation is often the treatment of choice. Kyphoplasty and vertebroplasty are commonly used techniques for patients who have osteolytic spine metastasis without neurologic compromise.