Current Treatment Modalities for Spinal Metastases Secondary to Thyroid Carcinoma.

Kushchayeva YS1, Kushchayev SV, Wexler JA, Carroll NM, Preul MC, Teytelboym OM, Sonntag VK, Van Nostrand D, Burman KD, Boyle LM. Thyroid. 2014 Oct;24(10):1443-1455

The spine is the most common site of bone metastases due to thyroid cancer, which develop in more than 3% of patients with well-differentiated thyroid cancer. Nearly half of patients with bone metastases from thyroid cancer develop vertebral metastases. Spinal metastases are associated with significantly reduced quality of life due to pain, neurological deficit, and increased mortality. Treatment options for patients with thyroid spinal metastases include radioiodine therapy, pharmacologic therapy, and surgical treatments, with recent advances in radiosurgery and minimally invasive spinal surgery as well. Therapeutic interventions require a multidisciplinary approach and aim to control pain, preserve or improve neurologic function, optimize local tumor control, and improve quality of life. We have proposed a three-tiered approach to the management and practical algorithms for patients with spinal metastases from thyroid carcinoma. The introduction of novel and improved techniques for the treatment of spinal metastases has created the opportunity to significantly improve control of metastatic tumor growth and the quality of life for the patients with spinal metastases from thyroid cancer. In order for these options to be effectively used, a multidisciplinary approach must be applied in the management of the patients with thyroid spinal metastases
Comment-This is an extensive and thorough review of modalities for treatment of spinal mets from thyroid cancer, and is a very useful resource for any therapist confronting this common and difficult prpoblem. L De Groot,MD

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