Surgical Approach to Metastatic Bone Disease

The treatment of metastatic cancer that has spread to the bone is predicated on palliation, not cure. Patients can still derive great benefit from surgical intervention. The prevention of fracture, maintenance of function, and relief of pain are the primary objectives of surgical intervention. Orthopaedic surgeons possess several techniques by which these goals may be realized. This article presents a general strategy for approaching patients with metastatic bone disease and the manner in which different implants may be used to attain the goals of palliation. As with the treatment of primary bone and soft tissue neoplasia, the care of patients with metastatic bone disease should be a multidisciplinary approach that includes orthopaedic surgeons, medical and radiation oncologists, nurses, social workers, physical therapists, the patients, and their families.