Progress in oncological therapy within the last decade has enhanced th
e survival time of patients suffering from tumorous osteolyses of the
spine. While the necessity of surgical intervention is often settled b
y acute clinical symptoms, the extent of surgery is certainly codeterm
ined by the patient's expectations and the time of survival to be expe
cted. We therefore developed a specific tumor algorithm for operations
on the spine with special emphasis on prognosis and the attainable qu
ality of life. The results of 154 patients with tumorous osteolyses of
the thoracic and lumbar spine, who were treated according to our algo
rithm, underline the unequivocal advantages of initially posterior pro
cedures.