Table 3.

Current NOMS decision framework

Low-grade ESCC is defined as grade 0 or 1 on Spine Oncology Study Group scoring system [5]. High-grade ESCC is defined as grade 2 or 3 on the ESCC scale [5]. Stabilization options include percutaneous cement augmentation, percutaneous pedicle screw instrumentation, and open instrumentation. For patients with significant systemic comorbidities that affect the ability to tolerate open surgery, stabilization may be limited to cement augmentation and/or percutaneous screw augmentation.

Abbreviations: cEBRT, conventional external beam radiation; ESCC, epidural spinal cord compression; NOMS, neurologic, oncologic, mechanical, and systemic; SRS, stereotactic radiosurgery.