Guidelines for integrated traditional Chinese and Western medicine diagnosis and treatment of spinal metastases (2025 Version)_Chinese Journal of Evidence-Based Medicine

Authors：

 YIN Mengchen ¹ ,  WANG Shuqiang ¹ ,  MO Wen ² , XIAO Jianru ³ , YANG Xinghai ³ , YAN Wangjun ⁴ , WEI Feng ⁵ , FANG Bin ⁶ , LIU Aifeng ⁷ , YANG Shaofeng ⁸ , LI Nianhu ⁹ , CHEN Bolai ¹⁰ , LIU Jintao ¹¹ , QIAN Yu ¹² , PAN Hao ¹³ , WEI Xu ¹⁴ , XU Xilin ¹⁵ , LI Xiaofeng ¹⁶

1. Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P. R. China;
2. Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P. R. China;
3. Changzheng Hospital, Naval Medical University, Shanghai 200003, P. R. China;
4. Shanghai Cancer Center, Fudan University, Shanghai 200032, P. R. China;
5. Peking University Third Hospital, Beijing 100191, P. R. China;
6. First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, P. R. China;
7. First Affiliated Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P. R. China;
8. First Affiliated Hospital, Hunan University of Traditional Chinese Medicine, Changsha 410007, P. R. China;
9. Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, P. R. China;
10. Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, P. R. China;
11. Suzhou Traditional Chinese Medicine Hospital, Nanjing University of Traditional Chinese Medicine, Suzhou 215002, P. R. China;
12. Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310006, P. R. China;
13. Hangzhou Traditional Chinese Medicine Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou 310007, P. R. China;
14. Wang Jing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, P. R. China;
15. Third Affiliated Hospital, Heilongjiang University of Traditional Chinese Medicine, Haerbin 150036, P. R. China;
16. Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P. R. China;

Corresponding author：

YIN Mengchen, Email: yinmengchen0513@126.com; WANG Shuqiang, Email: misspinal@163.com; MO Wen, Email: mw2218@126.com

Keywords：

Spinal metastases; Integrated traditional Chinese and Western medicine; Diagnosis and treatment guidelines

DOI：

10.7507/1672-2531.202507121

Video：

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Abstract Full text Figures/Tables Video References Cited by

The spine is one of the most common sites for bone metastases from malignant tumors, and its incidence is increasing year by year. It often leads to severe pain, pathological fractures, nerve compression, and spinal cord dysfunction, seriously affecting the quality of life of patients. The comprehensive treatment of spinal metastases with both traditional Chinese and Western medicine has shown significant efficacy, especially in improving clinical symptoms, promoting postoperative recovery as soon as possible, and enhancing the quality of life. Based on the latest research progress at home and abroad and from the perspective of clinical application, this guideline, grounded in evidence-based medical evidence, has formed 25 recommendations covering treatment objectives, efficacy evaluation, rational selection of traditional Chinese medicine, treatment plans, and postoperative rehabilitation. It provides diagnostic and therapeutic suggestions for orthopedic oncologists, oncologists, radiologists, pain specialists, and other professionals engaged in traditional Chinese medicine, Western medicine, or integrated traditional Chinese and Western medicine, as well as specialized nurses.

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1. Yu W, Chen D, Ding X, et al. A critical appraisal of clinical practice guidelines on surgical treatments for spinal metastasis. Eur Spine J, 2024, 33(5): 1868-1898.
2. Zheng J, Ding X, Wu J, et al. Prognostic factors and outcomes of surgical intervention for patients with spinal metastases secondary to lung cancer: an update systematic review and meta analysis. Eur Spine J, 2023, 32(1): 228-243.
3. Chen D, Yu W, Yin M, et al. A critical appraisal of clinical guidelines on radiotherapy treatments for spinal metastasis. Neurosurg Rev, 2025, 48(1): 446.
4. 李熙雷, 董健. 脊柱转移瘤外科治疗的再认识. 中国脊柱脊髓杂志, 2023, 33(4): 289-291.
5. 伦登兴, 胡永成. 更新观念, 明确脊柱转移瘤治疗的目标. 中国脊柱脊髓杂志, 2024, 34(12): 1233-1235.
6. 于文龙, 张帆, 陈定榜, 等. 基于德尔菲法脊柱转移瘤中医核心证候集的构建. 中国中医骨伤科杂志, 2025, 33(5): 56-60,68.
7. 尹萌辰, 刘韩森, 李林, 等. 脊柱转移瘤预后评分系统的研究进展. 中国脊柱脊髓杂志, 2023, 33(4): 344-352.
8. Chow E, Harris K, Fung K. Successful validation of a survival prediction model in patients with metastases in the spinal column. Int J Radiat Oncol Biol Phys, 2006, 65(5): 1522-1527.
9. Tabourel G, Terrier LM, Dubory A, et al. Are spine metastasis survival scoring systems outdated and do they underestimate life expectancy. Caution in surgical recommendation guidance. J Neurosurg Spine, 2021, 35(4): 527-534.
10. Massaad E, Hadzipasic M, Alvarez-Breckenridge C, et al. Predicting tumor-specific survival in patients with spinal metastatic renal cell carcinoma: which scoring system is most accurate. J Neurosurg Spine, 2020, 33(4): 529-539.
11. Schoenfeld AJ, Ferrone ML, Schwab JH, et al. Prospective validation of a clinical prediction score for survival in patients with spinal metastases: the New England Spinal Metastasis Score. Spine J, 2021, 21(1): 28-36.
12. De la Garza Ramos R, Naidu I, Choi JH, et al. Comparison of three predictive scoring systems for morbidity in oncological spine surgery. J Clin Neurosci, 2021, 94: 13-17.
13. Schoenfeld AJ, Ferrone ML, Blucher JA, et al. Prospective comparison of the accuracy of the New England Spinal Metastasis Score (NESMS) to legacy scoring systems in prognosticating outcomes following treatment of spinal metastases. Spine J, 2022, 22(1): 39-48.
14. Xiong GX, Fisher MWA, Schwab JH, et al. A natural history of patients treated operatively and nonoperatively for spinal metastases over 2 years following treatment: survival and functional outcomes. Spine (Phila Pa 1976), 2022, 47(7): 515-522.
15. Sharif S, Afsar A, Zileli M, et al. Outcome prediction, quality of life, and life expectancy in metastatic spine tumors: WFNS spine committee recommendation. Neurosurg Rev, 2025, 48(1): 160.
16. Bozzetti F, Mariani L, Lo Vullo S, et al. The nutritional risk in oncology: a study of 1, 453 cancer outpatients. Support Care Cancer, 2012, 20(8): 1919-1928.
17. Versteeg AL, van Tol FR, Lehr AM, et al. Malnutrition in patients who underwent surgery for spinal metastases. Ann Transl Med, 2019, 7(10): 213.
18. Rigney GH, Massaad E, Kiapour A, et al. Implication of nutritional status for adverse outcomes after surgery for metastatic spine tumors. J Neurosurg Spine, 2023, 39(4): 557-567.
19. De la Garza Ramos R, Charest-Morin R, Goodwin CR, et al. Malnutrition in spine oncology: where are we and what are we measuring. Global Spine J, 2025, 15(1_suppl): 29S-46S.
20. Kumar S, van Popta D, Rodrigues-Pinto R, et al. Risk factors for wound infection in surgery for spinal metastasis. Eur Spine J, 2015, 24(3): 528-532.
21. Ehresman J, Ahmed AK, Schilling A, et al. Preoperative nutrition consults associated with decreased postoperative complication rate and decreased length of hospital stay after spine metastasis surgery. World Neurosurg, 2020, 133: e173-e179.
22. Xu K, Li J, Hu M, et al. Prognostic significance of preoperative inflammatory biomarkers and traditional clinical parameters in patients with spinal metastasis from clear cell renal cell carcinoma: a retrospective study of 95 patients in a single center. Cancer Manag Res, 2020, 12: 59-70.
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Latest ArticlesGuidelines for integrated traditional Chinese and Western medicine diagnosis and treatment of spinal metastases (2025 Version)

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