Local and Distant Staging

Primary spinal tumors are relatively rare, representing 11% of primary musculoskeletal tumors and about 4% of all spinal tumors. Their management depends on their local and distant spread. Whenever it is feasible, en bloc resection with clear margins is the preferred surgical approach for malignant and aggressive benign tumors in order to achieve local control of the disease. An accurate preoperative evaluation is therefore mandatory for adequate surgical planning. Because spinal tumors are very rare, the main oncologic staging systems applied to them are those originally developed for appendicular location. However, the spine presents some particularities that distinguish it from extremities, namely the proximity to the spinal cord and the concern for spinal stability. These differences limit the application of the same surgical concepts that are applied in appendicular tumors. A surgical staging system dedicated to the spine and considering these particularities is therefore necessary. Imaging plays a key role in assessing the staging of tumors. Therefore, the knowledge of the main staging systems and the contribution of the different imaging modalities is necessary for the radiologist to provide an accurate staging report.