Presentation on theme: "Modern Treatment of Spinal metastases"— Presentation transcript:
1Modern Treatment of Spinal metastases Maxwell Boakye, MD MPH FACS FAANSAssociate Professor of NeurosurgeryNelson Endowed ChairCenter for Advanced Neurosurgery, University of Louisville
2My BackgroundNeurosurgeonResidency 2002Fellowships-complex spine-Emory and Spine Oncology-Sloan Kettering-2003Stanford worked with cyberknifeSpecial interest in spine tumors and spine radiosurgery
3GoalsEpidemiologyPresentationImagingRole of SurgeryEmerging Treatment paradigmsDecision making and FrameworksMemorial Sloan Kettering NOMS criteriaCases
4Epidemiology20000 new cases of metastatic epidural cord compression each year10% of cancer patients will develop spinal metastaticAbout 70% of all cancer deaths occur in elderly patients aged over 65Postmortem studies metastases present in 90% of patients with systemic cancer
5EpidemiologyNumber of elderly patients dying from cancer will double by 2030By age 2050, the number of newly diagnosed patients aged 85 will quadruple
6Myelopathy-Motor, Sensory, Bowel/Bladder Pain Signs and symptomsMyelopathy-Motor, Sensory, Bowel/BladderUsually from epidural cord compressionPainBiologicnocturnal/early morning-resolves during day-usually from tumor infiltration, Steroid responsiveMechanical-movement relatedRadicular-usually epidural disease in foramenOther Symptoms e.g LOC or AMS from brain
25CYBERKNIFE RADIOSURGERY The CyberKnife® a robotic manipulator to move a compact linear accelerator with six degrees of freedomReal-Time Image Guidance Throughout the TreatmentDynamic Motion TrackingAllows for accuracy and conformalityLouisville is getting one!!