This comprehensive text focuses exclusively on the management of metastatic spinal disease, evaluating the most recent literature and providing patient-centered treatment algorithms. Beginning with initial imaging, classification and clinical decision-making, the spine is approached anatomically from the upper cervical to the sacrum, describing the unique considerations and approaches appropriate to each region, such as laminectomy and stabilization, en bloc spondylectomy and resection and reconstruction. Less invasive and minimally invasive approaches are discussed throughout the text. Radiation therapy modalities and other adjuvant treatments are also discussed, as well as reconstructive flap coverage and the management of complications. 

The spinal column is the most common site of metastatic cancer, and a multidisciplinary approach is required to provide patients with reasonable management options to prevent and treat the disabling symptoms caused by this debilitatingcondition. This compendium of experience from thought leaders in the treatment of metastatic spine disease will provide spine surgeons, oncologists, radiation oncologists, physiatrists and palliative care specialists with up-to-date information to guide their patients through the multidisciplinary management of metastatic spinal disease.

MOSS: A Patient Centered Approach

Relative Radiosensitivity of Metastatic Spine Disease.- Relative Chemo-, Hormonal, and Immunosensitivity.- Noms.- Spinal Instability in Metastatic Disease.- Imaging Metastatic Spinal Disease.- Management of metastatic spinal cord compression without stereotactic radiotherapy and targeted adjuvant chemotherapy.- Metastatic Spine Disease: Critical Evaluation of the Current Literature.- Indications for en Bloc Spondylectomy for Metastatic Spine Disease.- Occipitocervical and Upper Cervical Metastatic Spinal Disease.- Mid-Cervical Metastatic Spinal Disease.- Cervicothoracic Metastatic Spine Disease.- Surgical Treatment for Patients with Thoracic Spinal Metastasis.- Thoracolumbar Metastatic Spinal Disease.- Indications and Techniques for Anterior Thoracolumbar Resections and Reconstructions
Metastatic Disease of the Lumbar Spine.- Vertebral Body Reconstruction in Metastatic SpineDisease.- Lumbosacral Metastatic Spine Disease
Sacral Metastases.- Radiation Therapy for Spinal Metastases.- Reconstructive Flap Coverage.- Complications .- Percutaneous Thermal Ablation of Spine Metastasis.- Minimally invasive spine surgery for metastatic spine disease  .