Vertebral compression fracture after stereotactic body radiotherapy for spinal metastases

Lancet Oncol. 2013 Jul;14(8):e310-20. doi: 10.1016/S1470-2045(13)70101-3.


The use of stereotactic body radiotherapy for metastatic spinal tumours is increasing. Serious adverse events for this treatment include vertebral compression fracture (VCF) and radiation myelopathy. Although VCF is a fairly low-risk adverse event (approximately 5% risk) after conventional radiotherapy, crude risk estimates for VCF after spinal SBRT range from 11% to 39%. In this Review, we summarise the evidence and predictive factors for VCF induced by spinal SBRT, review the pathophysiology of VCF in the metastatic spine, and discuss strategies used to prevent and manage this potentially disabling complication.

Publication types

  • Review

MeSH terms

  • Fractures, Compression / diagnosis
  • Fractures, Compression / etiology*
  • Fractures, Compression / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Orthopedic Procedures
  • Patient Selection
  • Predictive Value of Tests
  • Radiation Dosage
  • Radiation Injuries / diagnosis
  • Radiation Injuries / etiology*
  • Radiation Injuries / surgery
  • Radiosurgery / adverse effects*
  • Reoperation
  • Risk Assessment
  • Risk Factors
  • Spinal Fractures / diagnosis
  • Spinal Fractures / etiology*
  • Spinal Fractures / surgery
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome