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The NOMS decision framework is the cornerstone of multidisciplinary treatment in the modern management of metastatic spine tumors. The four sentinel decision points represented in NOMS are Neurologic, Oncologic, Mechanical stability and Systemic disease to decide the best treatment, including radiation, surgery, and systemic therapy. NOMS is updated every 2 years to integrate new technologies and evidence-based medicine as they become available, and thus the algorithm has changed dramatically since its inception over 20 years ago. This chapter represents the most contemporary iteration of NOMS to facilitate optimal decision-making in the very complicated metastatic spine tumor population.

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NOMS: Roadmap to Multidisciplinary Metastatic Spine Tumor Management

  • 章节

  • 发表日期：

    2025年

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  • Mark H. Bilsky,
  • Alexandra Giantini-Larsen,
  • Natasha Kharas,
  • W. Christopher Newman,
  • Yoshiya Yamada

摘要

The NOMS decision framework is the cornerstone of multidisciplinary treatment in the modern management of metastatic spine tumors. The four sentinel decision points represented in NOMS are Neurologic, Oncologic, Mechanical stability and Systemic disease to decide the best treatment, including radiation, surgery, and systemic therapy. NOMS is updated every 2 years to integrate new technologies and evidence-based medicine as they become available, and thus the algorithm has changed dramatically since its inception over 20 years ago. This chapter represents the most contemporary iteration of NOMS to facilitate optimal decision-making in the very complicated metastatic spine tumor population.