A Review Article on CyberKnife Stereotactic Radiosurgery for Spinal Lesions

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The efficacy of the CyberKnife [Accuracy, Inc., Sunnyvale CA], a new stereotactic radiosurgery device utilized in the treatment of benign and malignant spinal tumors, is reviewed. The study assesses the number and type of spinal tumors safely and effectively treated with CyberKnife radiosurgery. Most reports concerning the utilization of CyberKnife stereotactic radiosurgery [CSR] for the treatment of malignant [primary, metastatic] or benign spinal lesions have been published within the last 5 years. CSR may be administered alone or in conjunction with surgery and external beam radiation therapy. A major benefit of CSR is that it can be completed within 1 week [1-5 fractions] as compared with the several weeks required for external beam radiotherapy, with limited toxicity. A frameless device, the CSR’s accuracy is +/- 1 mm. Additionally, the Xsight program now allows the cervical and lumbar spine to be treated without fiducial marker placement; however, this is still required to accurately target thoracic lesions. CyberKnife radiosurgery is effective in treating both benign and malignant lesions. For benign tumors, the CSR successfully arrests tumor progression and minimizes pain. It is unique for the management/palliation of malignant metastatic disease where it functions as an adjunct or alternative to invasive surgery and/or routine external beam radiotherapy. In summary, CyberKnife stereotactic radiosurgery, approved by the Federal Drug Administration [USA 2001], may be safely and effectively administered within 1 week’s time to treat both benign and malignant spinal lesions with limited toxicity.