Upcoming Webinars

Associate Professor
Director of Spinal Oncology Multi-Disciplinary Program
Department of Radiation Oncology and Molecular Radiation Sciences
The Johns Hopkins University
Baltimore, MD, USA

May 21, 2021, 1:00PM BST

Post-operative spine SBRT is being increasingly performed at both community and academic practices.  However, there are specific nuances for post-operative cases that are unique and a firm understanding of the surgery performed is essential. This webinar will include a brief introduction to spine SBRT.  We will then review of current surgical trends and techniques, including epidural disease grading and assessment of spinal instability using the SINS scoring system; the pros and cons of surgery in patients with metastatic disease and why prophylactic surgery may be undertaken for instability; an overview of en bloc surgery and minimally invasive surgery.  Next we will review current data on conventional post-operative radiation therapy versus post-operative spine SBRT with a focus on local control and pain control including a discussion of the degree of epidural resection that is optimal. We will present a detailed description of the post-operative spine SBRT radiation technique, including delineation of the optimal target volume; organ at risk delineation including precise delineation of the cord when there is hardware creating artifact on MRI; accounting for hardware in treatment planning; toxicities unique to post-operative patients such as hardware failure or fracture;  and reasonable dose constraints for radiation naïve and previously irradiated patients.  We will end by discussing future directions and research questions including trends towards more limited surgery and use of post-operative SBRT to consolidate.