ACR Appropriateness Criteria Metastatic Epidural Spinal Cord Compression and Recurrent Spinal Metastasis

This is a clinical practice guideline for patients with recurrent spinal metastasis resulting in metastatic epidural spinal cord compression. The guideline examines the appropriateness of various treatment options including systemic therapy, surgical intervention, radiation therapy, osteoclast inhibitors and hospice care. The appropriateness of different techniques for unique clinical situations is discussed. Outcomes of interest include neurologic status, performance status, extent of disease, spine stability and life expectancy.