CLINICAL OUTCOME AND SURVIVAL AFTER TREATMENT OF METASTATIC SPINAL TUMORS

Spinal metastases present a complex clinical challenge, requiring a balance between oncological control, neurological preservation, and mechanical stabilization. Advances in modern imaging have increased the detection of vertebral metastases, coinciding with longer cancer survival due to system-ic therapy improvements. Spinal involvement often leads to severe pain, mechanical instability, and neurological deficits, significantly compromising quality of life. Various therapeutic strategies includ-ing surgery, radiotherapy, chemotherapy, and minimally invasive techniques have been developed to address these issues. Treatment selection is largely influenced by prognostic factors such as primary tumor type, performance status, neurological function, and expected survival. Prognostic scoring sys-tems, such as Tokuhashi and Tomita, are frequently utilized but may not fully capture current treat-ment advances. Surgical interventions aim to achieve neurological decompression and stabilization, yet carry variable complication risks. Effective pain control, preservation of ambulation, and mainte-nance of independence remain central goals, even in palliative settings. Quality-of-life improvement is multifactorial, encompassing functional restoration, pain relief, and psychological benefits. A mul-tidisciplinary approach, integrating neurosurgery, oncology, radiology, and rehabilitation, is essential for optimal patient selection and individualized treatment planning. This chapter summarizes clinical outcomes and survival determinants following treatment of spinal metastases, providing a comprehen-sive overview of prognostic factors and therapeutic implications.