Application of deformity principles in the management of spinal neoplasms: A Primer

Zach Pennington, Department of Neurosurgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States.
Joseph H. Schwab, Department of Orthopedics, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
Sheng-Fu Larry Lo, Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, 300 Community Dr., 9 Tower, Manhasset, NY 11030, United States.
C Rory Goodwin, Department of Neurosurgery, Duke University School of Medicine, 10 Duke Medicine Cir, Durham, NC 27710, United States.
Matthew L. Goodwin, Department of Orthopedic Surgery, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, United States.
Matthew Colman, Midwest Orthopedics, Rush University School of Medicine, 1620 W Harrison St, Chicago, IL 60612, United States.
Raphaële Charest-Morin, Department of Orthopedics, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada.
Nicolas Dea, Department of Orthopedics, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada.
Daniel Lubelski, Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, United States.
Ali Ozturk, Department of Neurosurgery, University of Pennsylvania School of Medicine, 3400 Civic Center BLvd, Philadelphia, PA 19104, United States.
Jacob M. Buchowski, Department of Orthopedic Surgery, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, United States.
Wende Gibbs, Department of Radiology, Barrow Neurological Institute, 2910 North Third Avenue, Phoenix, AZ 85013, United States.
Wesley Hsu, Department of Neurosurgery, Wake Forest University School of Medicine, 475 Vine St, Winston Salem, NC 27101, United States.
Ajit Krishnaney, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States.
Ilya Laufer, Department of Neurosurgery, New York University School of Medicine, 550 First Avenue, New York, NY 10016, United States.
Mohamed Macki, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States.
Addisu Mesfin, Department of Orthopedics, MedStar Health, 3800 Reservoir Rd NW, Washington DC 20007, United States.
Ganesh Shankar, Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States.
Dan Tobert, Department of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States.
John Shin, Department of Neurosurgery, University of Pennsylvania School of Medicine, 3400 Civic Center BLvd, Philadelphia, PA 19104, United States.
Andrew Platt, Department of Neurological Surgery, Kaiser Permanente - Fontana Medical Center, 9961 Sierra Ave, Fontana, CA 92335, United States.
Daniel M. Sciubba, Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, 300 Community Dr., 9 Tower, Manhasset, NY 11030, United States.

Document Type

Article

Abstract

BACKGROUND: With advances in surgical techniques, radiation, and systemic therapy, prognoses and quality of life have improved amongst patients with primary and metastatic vertebral column tumors. Sagittal deformity is known to have an adverse impact on patient quality of life but has been largely ignored in this study population. METHODS: A comprehensive literature review was conducted, focusing on articles germane to the study of spinal deformity in the context of oncologic disease. Articles included those focusing on bone health, the association of spinal deformity with oncologic spine disease, and both pelvic and anterior column reconstruction in patients treated for primary tumors. RESULTS: Little to date has focused specifically on the management of spinal deformity in the context of spinal tumors. However, it is known that tumor involvement of the vertebral column is associated with poorer screw purchase, which can be further worsened by radiotherapy. Instrumentation techniques that seek to address underlying deformity must also balance the need for radiographic follow-up, which is improved with novel carbon fiber-reinforced polyetheretherketone implants, and the need for intraoperative contouring. Last, residual deformity is associated with poorer patient reported outcomes and increased mechanical complications in adult spinal deformity, but better study within the spinal oncology population is merited. CONCLUSION: The potential negative impact of spinal deformity on patient quality of life in the spinal oncology population is now better appreciated amongst spinal oncologists, but studies have been limited to date. Further investigation is merited as survival outcomes continue to improve.

Publication Date

9-1-2025

Publication Title

North American Spine Society journal

E-ISSN

2666-5484

Volume

23

First Page

100779

PubMed ID

40979538

Digital Object Identifier (DOI)

10.1016/j.xnsj.2025.100779

Link to Full Text

Share

COinS