General
What are the common mets to spine/ bone? (what to examine) Which mets are typically blastic? Special investigation for Spine Mets? What is the pathophysiology of metastasis? SPINE METS
How will you assess this patient with suspected Spine Mets? #📜 How much bone involvement must there be to be seen on XR? What is the difference in MRI for Infection vs Tumor vs TB? What is the pathogenesis of Hematogenous spread mets/ infection/ TB to spine? Usually which part affected first? What is your initial management for spine mets? What is your definitive management? Any framework? How do you assess the Neurological component? How do you assess the Oncologic component? How do you assess the Mechanical component? How do you assess the Systemic component? What tumors will you consider Pre-op angioembolization? Any landmark paper for Spinal mets? Management of Oligometastatic disease? What is separation surgery? How to reduce wound complications post op? Aware of PEEK and carbon implants? LONG BONE METS
What is the Mirel's score? Special technique for nails? CASE: PATHOLOGICAL FRACTURE
How will you evaluate and manage this patient if no history of cancer? How will you evaluate this patient with history of cancer but unknown mets? How do you manage this fracture after workup? Case: Open pathological fracture
What are your considerations and approach to open pathological fracture? - 2. Ex fix for temporary stability while waiting for definitive treatment
- 3. Complete work up after ex fix- local and systemic staging
4. MDT to decide curative or palliative 
