Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2016; 7(2): 109-116
Published online Feb 18, 2016. doi: 10.5312/wjo.v7.i2.109
Tumors of the spine
Mert Ciftdemir, Murat Kaya, Esref Selcuk, Erol Yalniz
Mert Ciftdemir, Murat Kaya, Esref Selcuk, Erol Yalniz, Department of Orthopaedics and Traumatology, Trakya University School of Medicine, 22030 Edirne, Turkey
Author contributions: Ciftdemir M wrote the manuscript, helped in literature review and making the tables, and checked the references; Kaya M, Selcuk E and Yalniz E performed the literature review and drafted the article; all authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest related to the work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Mert Ciftdemir, MD, Assistant Professor, Department of Orthopaedics and Traumatology, Trakya University School of Medicine, Balkan Yerleskesi, 22030 Edirne, Turkey.
Telephone: +90-532-7653385 Fax: +90-284-2133899
Received: May 12, 2015
Peer-review started: May 18, 2015
First decision: August 19, 2015
Revised: September 20, 2015
Accepted: November 13, 2015
Article in press: November 17, 2015
Published online: February 18, 2016

Spine tumors comprise a small percentage of reasons for back pain and other symptoms originating in the spine. The majority of the tumors involving the spinal column are metastases of visceral organ cancers which are mostly seen in older patients. Primary musculoskeletal system sarcomas involving the spinal column are rare. Benign tumors and tumor-like lesions of the musculoskeletal system are mostly seen in young patients and often cause instability and canal compromise. Optimal diagnosis and treatment of spine tumors require a multidisciplinary approach and thorough knowledge of both spine surgery and musculoskeletal tumor surgery. Either primary or metastatic tumors involving the spine are demanding problems in terms of diagnosis and treatment. Spinal instability and neurological compromise are the main and critical problems in patients with tumors of the spinal column. In the past, only a few treatment options aiming short-term control were available for treatment of primary and metastatic spine tumors. Spine surgeons adapted their approach for spine tumors according to orthopaedic oncologic principles in the last 20 years. Advances in imaging, surgical techniques and implant technology resulted in better diagnosis and surgical treatment options, especially for primary tumors. Also, modern chemotherapy drugs and regimens with new radiotherapy and radiosurgery options caused moderate to long-term local and systemic control for even primary sarcomas involving the spinal column.

Keywords: Spinal column, Sarcoma, Metastasis, Spinal neoplasms, Palliative surgery

Core tip: Primary tumors involving the spine are rare, while spinal column metastases are present in up to 70% of cancer patients. Both primary and metastatic tumors of the spine are often asymptomatic or have non-specific symptoms because in spine tumors, delayed diagnosis is not very unusual. Goal of treatment in spinal column metastases is to optimize the patient’s quality of life by providing effective pain relief and preserving or restoring neurological functions. Treatment strategy for primary tumors should be planned after both oncological and surgical staging. Because of that, biopsy is a very important step in primary tumors. Surgery in metastatic tumors are mostly palliative, aiming short-term control. Primary benign and malignant lesions mainly cause canal compromise and are treated surgically according to oncological staging and Weinstein-Boriani-Biagini classification.