Anterior spinal separation surgery to allow for stereotactic body radiotherapy: a novel approach permitting radical oncological treatment of oligometastatic disease

The treatment of spinal cancers has rapidly evolved in the past decade. Often the treatment for spinal metastases required highly morbid surgeries and with palliative outcomes. However, a paradigm shift in surgical oncology has allowed spinal metastases treatment to have curative results. In the state of oligometastatic disease (OMD), the accompaniment of Stereotactic Body Radiotherapy (SBRT) as a primary modality or adjuvant treatment to surgery has been shown to excellent survival outcomes, lower morbidities and better pain management. This case report illustrates a novel approach to the treatment of spinal OMD utilizing anterior spinal separation surgery with a custom carbon fibre vertebral body replacement cage followed by postoperative SBRT with excellent radio-oncological outcomes over 30-month follow-up.