Stereotactic Radiosurgery for Residents-Integrated Decision-Making in the Management of Metastatic Spine Disease: NOMS

Video Transcription

Video Summary

In this video, the speaker discusses the management of metastatic spine disease, focusing on an integrated decision-making framework called the neurologic-oncologic mechanical systemic (NOMS) disease framework. The speaker explains that improvements in MR imaging and systemic treatments have led to an increased number of spine metastases. The integration of stereotactic radiosurgery into treatment paradigms has been a significant advancement, leading to improved outcomes. The speaker emphasizes that the goal of therapy for metastatic disease is palliative, aiming to achieve pain control, maintain neurologic status, achieve local tumor control, and improve quality of life. The effectiveness of different treatment approaches, such as conventional external beam radiation, stereotactic radiosurgery, and surgery, is discussed in relation to tumor histology and the degree of spinal cord compression. The importance of assessing stability and systemic disease is highlighted. The speaker also discusses the NOMS assessment criteria and scoring systems to guide treatment decisions for neurologic, oncologic, mechanical, and systemic factors. Case examples are provided to illustrate the decision-making process and the use of different treatment modalities. The speaker concludes by emphasizing the need to consider patient tolerance and the importance of individualized treatment plans based on the specific characteristics of each case.

Asset Subtitle

Presented by Mark H. Bilsky, MD, FAANS

Keywords

metastatic spine disease

neurologic-oncologic mechanical systemic

stereotactic radiosurgery

pain control

local tumor control

tumor histology

individualized treatment plans