AOSpine Knowledge Forum Tumor steering committee and associates meeting in Singapore, May 2018

Coming soon—AO Surgery Reference for Metastatic Spine Tumor—a tool to help you make the right treatment decision


The AOSpine Knowledge Forum Tumor treatment recommendations and classifications for metastatic spine tumor have been adopted and implemented into the AO Surgery Reference. The new module organizes concepts in a way that helps spine surgeons think systemically about their treatment indications and options. With this tool, clinical outcomes for spine tumor patients are expected to substantially improve.


“We’ve come a long way in finding out which patients benefit from surgery, defining clear treatment indications, surgical strategy recommendations, and studying treatment outcomes,” author Ilya Laufer explains. Another important component has been the development of scoring systems such as SINS (Spine Instability Neoplastic Score), that facilitates diagnosis and referral patterns for patients with spinal instability.




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Author Ilya Laufer, AO Surgery Reference Manager Lars Veum, and Editor Luiz Vialle finalizing the module in New York, March 2019.



With several AOSpine Knowledge Forum Tumor members, Laufer has arranged the information in a way that will help surgeons make the right decisions, make it easier to come up with a surgical plan, and to know exactly what techniques to use for each individual case.


“The AO Surgery Reference for Metastatic Spine Tumor is the only tool of its kind guiding decision-making and access to recommended surgical techniques at a moment’s notice—accessible anytime, anywhere on hand-held devices.”Coauthor J J Verlaan thinks the biggest advantage for spine surgeons caring for these patients is having access to concepts that have been tested and are backed by scientific evidence of effectiveness and safety. “For every patient with spinal metastases there are so many variables that may influence outcome. Some form of standardization and a more methodological approach were urgently needed.”




Latest information at your fingertips

Verlaan remembers that only ten to fifteen years ago metastasized cancer was an almost certain death sentence. “As a result, doctors typically were not interested in investing much beyond best supportive care. But with systemic therapies, things have changed dramatically for the better; maintaining ambulation and quality of life have become the primary focus of physicians caring for these patients.”


More data-driven outcome measures and recommendations will come out of the AOSpine Knowledge Forum Tumor prospective studies and new knowledge will be added to the AO Surgery Reference as it becomes available. The user will always have the latest information at their fingertips.


Spine section Editor Luiz Vialle says the AO Surgery Reference is constantly evolving. “It was only natural that after spine trauma and deformities, we added tumor. I hope we can include the more complex primary tumors next.”


Vialle reveals there is a new AO Surgery Reference Platform in development, more user-friendly and allowing faster access to what the surgeon is looking for. “We are addressing the spine community’s needs by providing quick, up-“This module will highlight the key considerations and surgical indications, when it comes to the evaluation of the metastatic spine tumor patient.”to-date information on clinical and radiological evaluations, classifications, and decision-making processes, including a guide for performing the most common procedures.”


“This module will highlight the key considerations and surgical indications, when it comes to the evaluation of the metastatic spine tumor patient.”




Recommendations from the AOSpine Knowledge Forum Tumor are strong. Ilya Laufer speaking at the AOSpine Knowledge Forum Tumor meeting in Singapore, May 2018.Vialle thanks AOSpine Education Commission for their continued trust, which has been crucial to the Spine module’s success.“Seemingly similar cases can have vastly different outcomes after treatment that appears identical,” Verlaan says. “We still need to think in bigger concepts about impact on outcome.”1 - 3<>



A unique learning tool

Surgeons have a wide range of experience and variable access to decision-making instruments. In a newfangled way, AO Surgery Reference formalizes and popularizes surgical information and makes it accessible for clinicians across the world. It also makes it easier for those who are in training to learn how to take care of these patients.


“I’ve noticed many residents and fellows use the AO Surgery Reference routinely when it comes to trauma,” Laufer says. “I think spinal oncology has reached a point where we—like trauma—have a lot more clarity about how to take care of patients with spinal tumors.”

“The clinical outcome may improve substantially when you follow a rational path in deciding which treatment is going to benefit your patient.”

“Clarifying indications is key,” Laufer stresses. “In the modern age of hand-held devices, having something like this in the palm of a trainee’s hand is important. The easier the access, the better it will be known, and the more it will be used.”


Verlaan warns that such tools should not replace interaction with patients. “One should talk long and hard with patients to understand their wishes and goals before starting any treatment.”


“The clinical outcome may improve substantially when you follow a rational path in deciding which treatment is going to benefit your patient.”






Useful links


Access the AO Surgery Reference Spine section


AOSpine Knowledge Forum Tumor


Open access, evidence-based recommendations for spine oncology—Focus Issue by AOSpine Knowledge Forum Tumor


Start using the Spinal lnstability Neoplastic Score (SINS)










Newsletter 21 | May 2019

Newsletter 21

May 2019

AOSpine |


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