Presentation on theme: "Modern Treatment of Spinal metastases"— Presentation transcript:
1 Modern Treatment of Spinal metastases Maxwell Boakye, MD MPH FACS FAANSAssociate Professor of NeurosurgeryNelson Endowed ChairCenter for Advanced Neurosurgery, University of Louisville
2 My BackgroundNeurosurgeonResidency 2002Fellowships-complex spine-Emory and Spine Oncology-Sloan Kettering-2003Stanford worked with cyberknifeSpecial interest in spine tumors and spine radiosurgery
3 GoalsEpidemiologyPresentationImagingRole of SurgeryEmerging Treatment paradigmsDecision making and FrameworksMemorial Sloan Kettering NOMS criteriaCases
4 Epidemiology20000 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
5 EpidemiologyNumber of elderly patients dying from cancer will double by 2030By age 2050, the number of newly diagnosed patients aged 85 will quadruple
6 Myelopathy-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
25 CYBERKNIFE 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!!