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Controversies in Management of Metastatic Disease

Metastatic disease of the axial skeleton is on the rise as patients are living longer with their disease through advances in cancer treatment. UW Medicine physicians Ernest Conrad, Darin Davidson, and Joshua Lindsey discuss how the ideal treatment is a balance between providing surgical stability that allows for maximal functional outcome, while minimizing morbidity. Humeral and femoral lesions can be treated with plates, intramedullary nails or reconstructive implants. Each metastatic lesion provides a unique challenge to the treating surgeon and the diagnosis must be certain prior to definitive fixation. With patients with metastatic disease, each lesion is a complex problem that requires a patient-centered approach to optimize the outcome.