Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of adults with neoplastic vertebral fractures

Charles H. Cho; Steven W. Hwang; Daniel J. Mazanec; John E. O'Toole; William C. Watters; Thiru M. Annaswamy; Allan L. Brook; David S. Cheng; Sean D. Christie; Zachary A. Cupler; Dennis E. Enix; Marjorie Eskay-Auerbach; Justin M. Goehl; G. Alexander Jones; Piyush Kalakoti; Manish K. Kasliwal; Niranjan U. Kavadi; Cumhur Kilincer; Justin M. Lantz; Gazanfar Rahmathulla; Tom Reinsel; K. Aaron Shaw; Ahmed Shawky Abdelgawaad; Amy M. Skuteris; Jeffrey A. Stone; Andrea L. Strayer; Andrew N. Vo

doi:10.1016/j.spinee.2025.03.019

$Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of adults with neoplastic vertebral fractures$

Journal article

Peer reviewed

Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of adults with neoplastic vertebral fractures

Charles H. Cho, Steven W. Hwang, Daniel J. Mazanec, John E. O'Toole, William C. Watters, Thiru M. Annaswamy, Allan L. Brook, David S. Cheng, Sean D. Christie, Zachary A. Cupler, …

The spine journal, Vol.25(7), pp.1337-1346

07/2025

DOI: 10.1016/j.spinee.2025.03.019

PMID: 40154638

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Abstract

The North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Adults with Neoplastic Vertebral Fractures features evidence-based recommendations for diagnosing and treating adult patients with neoplastic vertebral fractures. The guideline is intended to reflect contemporary treatment concepts for neoplastic vertebral fractures as reflected in the highest quality clinical literature available on this subject as of October 2020. The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with neoplastic vertebral fractures. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition. This is a guideline summary review. This guideline is the product of NASS’ Clinical Practice Guidelines Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questions to address in the guideline. The literature search strategy was developed in consultation with a medical librarian. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guideline was submitted to an internal and external peer review process and ultimately approved by the NASS Board of Directors. Twenty-two clinical questions were addressed, and the answers are summarized in this article. The respective recommendations were graded according to the levels of evidence of the supporting literature. The evidence-based clinical guideline has been created using techniques of evidence-based medicine and best available evidence to aid practitioners in the diagnosis and treatment of adult patients with neoplastic vertebral fractures. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flowchart, suggestions for future research, and all of the references, is available electronically on the NASS website at http://www.spine.org/guidelines.

diagnosis

evidence-based guideline

Neoplastic

spine tumor, primary and metastatic

treatment

vertebral fracture

Details

Title: Subtitle: Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of adults with neoplastic vertebral fractures
Creators: Charles H. Cho - Brigham and Women's Hospital
Steven W. Hwang - Shriners Children's Philadelphia, Philadelphia, PA, USA
Daniel J. Mazanec - Cleveland Clinic
John E. O'Toole - Rush University Medical Center
William C. Watters - The University of Texas Health Science Center at Houston
Thiru M. Annaswamy - Pennsylvania State University
Allan L. Brook - Montefiore Medical Center
David S. Cheng - VA Long Beach Healthcare System
Sean D. Christie - Dalhousie University
Zachary A. Cupler - VA Butler Healthcare
Dennis E. Enix - St. Louis, MO, USA
Marjorie Eskay-Auerbach - Tucson, AZ, USA
Justin M. Goehl - Dartmouth Health
G. Alexander Jones - Endeavor Health, Elmhurst, IL, USA
Piyush Kalakoti
Manish K. Kasliwal - University Hospitals of Cleveland
Niranjan U. Kavadi - Oklahoma City VA Medical Center
Cumhur Kilincer - Trakya University
Justin M. Lantz - University of Southern California
Gazanfar Rahmathulla - Mayo Clinic Health System
Tom Reinsel - Cincinnati VA Medical Center
K. Aaron Shaw - Sisters of Mercy Health System
Ahmed Shawky Abdelgawaad
Amy M. Skuteris - North American Spine Society
Jeffrey A. Stone - Mayo Clinic in Florida
Andrea L. Strayer
Andrew N. Vo - Orthopaedic Associates of Wisconsin, Pewaukee, WI, USA
Resource Type: Journal article
Publication Details: The spine journal, Vol.25(7), pp.1337-1346
DOI: 10.1016/j.spinee.2025.03.019
PMID: 40154638
NLM abbreviation: Spine J
ISSN: 1529-9430
eISSN: 1878-1632
Publisher: Elsevier Inc
Grant note: North American Spine Society (NASS)
Development of this guideline was funded in its entirety by the North American Spine Society (NASS) . The NASS Clinical Practice Guidelines Committee developed this guideline.
Language: English
Electronic publication date: 03/26/2025
Date published: 07/2025
Academic Unit: Neurosurgery
Record Identifier: 9984803712602771

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