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Clinical Management of Spinal Tumor: Surgical Treatment, Radiotherapy and Systemic Therapy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 2029

Special Issue Editors

Dr. Riccardo Ghermandi

E-Mail Website
Guest Editor
Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
Interests: spinal surgery; primary spine tumors; spinal metastases; degenerative spine disease
Dr. Cristiana Griffoni

E-Mail Website
Guest Editor
Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
Interests: regenerative medicine; patient safety; quality of life
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Spinal tumors range from relatively rare primary tumors to the increasingly common metastatic disease of the spine. Although primary tumors of the spine are rare (<10% of spinal tumors), the number of patients with metastatic disease to the spine is substantial. Spinal metastases will be found in approximately 20% of all patients diagnosed with cancer (and in ≈70% of those with metastatic disease). The workup of the new spinal lesion can be challenging, and improper workup/treatment can lead to poor outcomes. By contrast, metastatic disease of the spine is relatively common, but multidisciplinary management is relevant for this pathology.

This Special Issue aims to provide an overview of current treatments for spinal tumors, both primary and metastatic, concerning surgery, radiotherapy, and systemic therapy, with a particular focus on innovative therapeutic pathways and multidisciplinary approaches.

Original research articles are especially requested, though a limited number of reviews can be accepted.

Dr. Riccardo Ghermandi
Dr. Cristiana Griffoni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • primary spinal tumors
  • metastatic spinal disease
  • surgery
  • radiotherapy
  • systemic therapy

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Published Papers (3 papers)

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11 pages, 4481 KiB  
Article
Electrochemotherapy in Aggressive Hemangioma of the Spine: A Case Series and Narrative Literature Review
by Giuseppe Tedesco, Luigi Emanuele Noli, Cristiana Griffoni, Riccardo Ghermandi, Giancarlo Facchini, Giuliano Peta, Nicolas Papalexis, Emanuela Asunis, Stefano Pasini and Alessandro Gasbarrini
J. Clin. Med. 2024, 13(5), 1239; https://doi.org/10.3390/jcm13051239 - 22 Feb 2024
Cited by 2 | Viewed by 1466
Abstract
(1) Background: this case series and literature review aims to evaluate the efficacy and safety of electrochemotherapy in the management of aggressive spinal hemangiomas, presenting two distinct cases. (2) Methods: we present two cases of spinal aggressive hemangioma which were refractory to conventional [...] Read more.
(1) Background: this case series and literature review aims to evaluate the efficacy and safety of electrochemotherapy in the management of aggressive spinal hemangiomas, presenting two distinct cases. (2) Methods: we present two cases of spinal aggressive hemangioma which were refractory to conventional treatments and underwent electrochemotherapy. Case 1 involves a 50-year-old female who presented with an aggressive spinal hemangioma of L1, who previously underwent various treatments including surgery, radio-chemotherapy, and arterial embolization. Case 2 describes a 16-year-old female with a T12 vertebral hemangioma, previously treated with surgery and stabilization, who faced limitations in treatment options due to her young age and the location of the hemangioma. (3) Results: in Case 1, electrochemotherapy with bleomycin was administered following the failure of previous treatments and resulted in the reduction of the lesion size and improvement in clinical symptoms. In Case 2, electrochemotherapy was chosen due to the risks associated with other treatments and was completed without any adverse events. Both cases demonstrated the potential of electrochemotherapy as a viable treatment option for spinal hemangiomas, especially in complex or recurrent cases. (4) Conclusions: electrochemotherapy with bleomycin is a promising treatment for aggressive spinal hemangiomas when conventional therapies are not feasible or have failed. Further research is needed to establish definitive protocols and long-term outcomes of electrochemotherapy in spinal hemangioma management. Full article
(This article belongs to the Special Issue Clinical Management of Spinal Tumor: Surgical Treatment, Radiotherapy and Systemic Therapy)
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13 pages, 5342 KiB  
Case Report
Hybrid Therapy with SBRT Target-Tailored Tumor Resection for High-Grade Metastatic Epidural Spinal Cord Compression (MESCC): Illustrative Case
by Mario De Robertis, Lorenzo Lo Faro, Linda Bianchini, Ali Baram, Leonardo Anselmi, Elena Clerici, Pierina Navarria, Marco Riva, Marta Scorsetti, Federico Pessina and Carlo Brembilla
J. Clin. Med. 2025, 14(5), 1688; https://doi.org/10.3390/jcm14051688 - 3 Mar 2025
Abstract
Background: Spinal metastases affect approximately 40% of patients with systemic cancers; metastatic epidural spinal cord compression (MESCC) occurs in up to 20% of cases and leads to potential significant morbidity. Recent advancements in high-dose conformal radiation techniques, such as Stereotactic Body Radiation Therapy [...] Read more.
Background: Spinal metastases affect approximately 40% of patients with systemic cancers; metastatic epidural spinal cord compression (MESCC) occurs in up to 20% of cases and leads to potential significant morbidity. Recent advancements in high-dose conformal radiation techniques, such as Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiosurgery (SRS), enable histology-independent ablative treatments, yet optimal dose fractionation remains undetermined. Methods and Results: This case of vertebral metastases with high-grade ESCC exemplifies the model of a comprehensive treatment workflow that emphasizes interdisciplinary collaboration, within the framework of a personalized medicine. The “Hybrid Therapy” combines Separation Surgery, aimed at achieving circumferential spinal cord decompression, with SBRT/SRS. The oncologic resection has been performed in a navigation-assisted technique that is tailored to the SBRT target, pre-operatively defined on the neuronavigation station. Conclusions: This seamless integration during initial planning of surgery with the ideal radio-oncological target is aimed at avoiding delays in referral and limitations in subsequent treatment options. This integrative holistic strategy not only prioritizes functional preservation, minimizing surgical invasiveness, but also promotes tumor control, thus offering potential promising new avenues for patient-centered oncologic care. Future high-quality studies are warranted to validate the widespread potential utility and safety of this approach. Full article
(This article belongs to the Special Issue Clinical Management of Spinal Tumor: Surgical Treatment, Radiotherapy and Systemic Therapy)
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18 pages, 2980 KiB  
Systematic Review
Systematic Review Comparing Open Versus Minimally Invasive Surgical Management of Intradural Extramedullary Tumours (IDEM)
by Asfand Baig Mirza, Ariadni Georgiannakis, Feras Fayez, Pak Yin Lam, Amisha Vastani, Christoforos Syrris, Dale Darbyshire, Kevin Tsang, Cheong Hung Lee, Amr Fahmy, Zaher Dannawi, Jose Pedro Lavrador, Irfan Malik, Gordan Grahovac, Jonathan Bull, Alexander Montgomery, Ali Nader-Sepahi, Taofiq Desmond Sanusi, Babak Arvin and Ahmed Ramadan Sadek
J. Clin. Med. 2025, 14(5), 1671; https://doi.org/10.3390/jcm14051671 - 1 Mar 2025
Viewed by 63
Abstract
Background/Objectives: Intradural extramedullary (IDEM) spinal tumours are relatively rare and predominantly benign. Gross total resection (GTR) has been demonstrated as an effective treatment, with increasing evidence supporting the use of minimally invasive techniques to achieve GTR. This study reviews the current surgical [...] Read more.
Background/Objectives: Intradural extramedullary (IDEM) spinal tumours are relatively rare and predominantly benign. Gross total resection (GTR) has been demonstrated as an effective treatment, with increasing evidence supporting the use of minimally invasive techniques to achieve GTR. This study reviews the current surgical management options for IDEM tumours and their outcomes. Methods: A systematic literature search without meta-analysis was conducted by two independent reviewers in December 2024. The population of interest comprised patients who underwent surgical treatment for IDEM tumours. Outcomes assessed included the extent of resection, postoperative neurological function, and complications. Results: Fifty-seven articles met the inclusion criteria, providing data on 4695 IDEM cases, of which 3495 were managed through open surgery and 750 via minimally invasive surgery. The extent of resection was high, with a mean GTR > 90% across studies. Open laminectomy and unilateral minimally invasive hemilaminectomy were the most common surgical approaches. Complications, such as cerebrospinal fluid leaks, were less frequent following minimally invasive procedures vs. open surgery (11.1% vs. 14.3%). Minimally invasive surgery also led to improved postoperative functional outcomes (mean McCormick score change −1.30 vs. −0.64) and a lower recurrence rate (1.4% vs. 10.0%). Conclusions: Whilst open surgery yields acceptable rates of resection and neurological improvement, there is growing evidence that minimally invasive surgery can achieve comparable, if not superior, rates of resection with fewer complications, leading to lower costs and shorter hospital stays. Full article
(This article belongs to the Special Issue Clinical Management of Spinal Tumor: Surgical Treatment, Radiotherapy and Systemic Therapy)
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