Spine
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Systematic review of literature. ⋯ There is very low quality evidence to support the superiority of one approach over another. There is a strong recommendation for posterior or posterior-lateral approach from T2 through T5. For the T6-L5 regions of the spine we recommend either anterior, posterior, or combined anterior and posterior surgery depending on the clinical presentation, surgeon and patient preference.
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Systematic review of the literature and consensus recommendations by an international expert focus group. ⋯ Patients with ES and OS are currently managed with multiple modalities involving surgery, radiation, and chemotherapy. For both histopathologies, advances in chemotherapy have led to the greatest improvements in survival over the last few decades. Neoadjuvant therapy portents the most favorable local control and long-term survival. En bloc surgical resection may improve overall survival and decrease risk of recurrence.
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Systematic review. ⋯ (1) Incisional biopsy or intralesional resection significantly increases the risk of local recurrence, therefore, transcutaneous computed tomography-guided trocar biopsy is recommended. When there is a suspicion of primary spine tumor, the surgeon who performs the definitive surgery should ideally perform or direct the biopsy procedure. (2) En bloc resection is achievable if staging determines that it is feasible. The adverse event profile of these surgeries is high even at experienced centers. Therefore, experienced, multidisciplinary teams should perform these surgeries. (3) Grade of Recommendation can be "strong recommendation, low-quality evidence."
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Systematic review. ⋯ The present data suggest that calcitonin administration in the treatment for neurogenic claudication has no benefit in patients with lumbar spinal stenosis.
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Narrative review. ⋯ Key opinion leaders using the GRADE System made treatment recommendations based on systematically reviewed evidence, blended with clinical expertise and patient preference on critical, controversial questions in spine oncology.