For Physicians: Treating the Spine with CyberKnife

Spine Plan

Here is an example of a bone metastasis in the spine that was treated with CyberKnife in one treatment.  The picture on the left shows this patient’s CT scan.  The white areas are the bone and the the dark gray area on the left side of the bone is the tumor.  The structures outlined in orange on either side of the bone are the kidneys.  The yellow line represents the dose of radiation that was given to the tumor and the orange line surrounding this represents the radiation dose given to the entire bone.  The picture on the right above shows a side view of the plan.  The dark pink line in both pictures represents the spinal cord.  The spinal cord is very sensitive to radiation and it is critical that it is avoided so that it is not damaged by the radiation.  One of the main benefits of CyberKnife radiation to the spine is that the tumor receives a very high dose, while the spinal cord does not.

Candidates for CyberKnife® to the spine

  • Primary spinal tumors
    • Surgery too risky
  • Metastatic Disease
    • Isolated area of spinal involvement
    • Prior spinal RT
    • Minimize chemo break

How does the CyberKnife® Treat spine tumors?

  • Xsight® Spine tracks and automatically corrects for spine motion
    • Direct tracking of skeletal structures
    • Allows for non-invasive tracking of spine motion
    • No rigid immobilization required
    • Results in sub-millimeter targeting accuracy
  • Fiducial markers sometimes required
    • spinal instrumentation
    • severe osteoporosis