Perioperative considerations in patients with metastatic bone disease

Preoperative assessment of patients with metastatic bone disease includes a history and physical examination, laboratory evaluation, and standard radi ographs. Perioperative diagnostics include technetium bone scan, CT scans, MX imaging, positron emission tomography, and biopsy. The role of preoperat ive tumor embolization and vena cava filter placement is discussed in this article. Guidelines for pain control are provided. Surgical planning and in strument considerations for long bone lesions, periarticular lesions, and p elvis and acetabular lesions are addressed. The importance of rehabilitatio n for patients with metastatic bone disease is emphasized.