AO Spine Knowledge Forum Tumor
A global clinical research group advancing spine oncology care worldwide
How the AO Spine Knowledge Forum Tumor improves patient care
AO Spine Knowledge Forum (KF) Tumor is an international group of dedicated spine oncology surgeons and oncologists who:
- implement physician-driven landmark clinical studies
- advance patient care through multicenter analysis and peer-reviewed publications
- focus on both metastatic and the very rare primary spine tumors
Practical tools for clinicians treating patients with spinal tumors
Focus Issue
Precision Medicine in Spinal Oncology: An Overview from the AO Spine Knowledge Forum Tumor, Global Spine Journal Vol 15 (1S) 2025.
This special focus issue represents a culmination of years of experience devoted to advancing the care of patients with both metastatic and primary spinal tumors.
Classification system
The Spinal Instability Neoplastic Score (SINS) is a classification tool for assessing tumor-related spinal instability. This tool facilitates appropriate surgical referral of patients with metastatic spine disease.
AO Spine Spinal lnstability Neoplastic Score (SINS) Graphical Table
Patient-reported outcome
The first spine oncology-specific patient-reported outcome (PRO) tool SOSGOQ2.0 allows you to define how your patients are improving and serves to improve their quality of life.
Download the SOSGOQ2.0 and use in combination with a generic instrument.
Patient questionnaires
Patient expectations questionnaires help clinicians understand what treatment outcomes spine oncology patients anticipate to improve patient satisfaction and care quality.
Download the questionnaire for patients receiving surgical treatment and/or radiotherapy treatment.
Knowledge Forum Reviews
The Global Spine Journal special collection of clinical practice recommendations by the Knowledge Forums helps busy clinicians operationalize and maintain their commitment to excellence and delivering the highest standard of care.
Educational offerings and resources for spine professionals interested in spinal oncology
AO Spine offers gold-standard courses and resources in the field of spine oncology for surgeons at different stages of their career. The AO’s publishing and knowledge sharing platforms will further help boost their impact and improve the care of spine oncology patients.
- AO Surgery Reference Tumor modules on primary and metastatic tumors
- Upcoming AO Spine courses
- Recorded Spine Tumor Lectures by the KF Tumor experts
- AO Videos (AO members access only)
- AO Spine Guest Blog posts on spine tumors
Ongoing research projects
Principal Investigator:
Ilya Laufer
Co-Principal Investigator:
Ori Barzilai
Goals:
To assess the effectiveness of surgery and radiotherapy in relieving pain for patients with metastatic spine disease. The proportions of responders and non-responders based on pain relief from the worst baseline index pain (the worst of one kind or multiple kinds of pain, if the patient has experienced multiple kinds of index pain at baseline) after surgery and/or radiotherapy will be described.
The AO Spine Cancer-Related Pain Classification will be used to categorize neoplastic spinal pain by etiology.
Secondary objectives include factors predicting pain relief and the relationship between pain and other patient-reported outcomes.
ClinicalTrials.gov Identifier: NCT06746103
Principal Investigators:
Ori Barzilai, Ilya Laufer
Goals:
To develop a core set of spine tumor pain descriptors and a mechanism-driven classification system for spine tumor pain assessment and focused pain experience measurement to guide treatment decisions.
Principal Investigators:
Consortium of 15 partners including AO Spine. Coordinated by ALMA MATER STUDIORUM - UNIVERSITA DI BOLOGNA
Goals:
To improve fracture prevention in patients with vertebral metastases by developing computational models that assess fracture risk. These models will be integrated into a Decision Support System (DSS) to help clinicians tailor treatments based on individual risk.
The project will also create new guidelines for patient stratification and treatment selection.
ClinicalTrials.gov Identifier: NCT06910618
Additional information:
A multicenter prospective registry for the management and outcomes of metastatic spine tumors
Principal Investigator:
Charles Fisher
Co-Principal Investigators:
Arjun Sahgal, Ilya Laufer
Goals:
To establish a network of spine oncology centers dedicated to prospective multicenter international research of patients diagnosed with metastatic tumors of the spine and will include a comprehensive prospective clinical database which will serve as a shared research platform.
The association of clinical, diagnostic, and therapeutic variables with patient reported outcomes, morbidity data, local tumor control, and survival will be investigated.
ClinicalTrials.gov Identifier: NCT02830451
Research Output:
Principal Investigator:
Jeremy Reynolds
Co-Principal Investigators:
Nicolas Dea, Laurence Rhines
Goals:
To establish a network of spine oncology centers dedicated to prospective multicenter international research of patients diagnosed with primary spinal column and cord tumors and will include a comprehensive prospective clinical database which will serve as a shared research platform.
The association of clinical, diagnostic, and therapeutic variables with survival, local recurrence, morbidity data, and patient reported outcomes will be investigated.
ClinicalTrials.gov Identifier: NCT02790983
Research Output:
Principal investigator:
Charles Fisher
Co-Principal investigator:
Ziya Gokaslan
Goals:
To prospectively collect patient, diagnostic and treatment variables along with disease-specific and generic health related quality of life (HRQOL) data on consecutively treated patients with metastatic spine tumors.
ClinicalTrials.gov Identifier: NCT01825161
Remark:
This project received co-funding from the Orthopaedic Research & Education Foundation (OREF) through a Spine Prospective Clinical Research Grant
Research Output:
Principal investigator:
Aron Lazary
Co-Principal investigator:
Nicolas Dea
Goals:
To develop a novel scoring system to guide surgical treatment of patients with spinal metastases.
Principal investigator:
Stephen Yip
Co-Principal investigators:
Raphaële Charest-Morin, Chetan Bettegowda, Nicolas Dea, Rory C. Goodwin
Goals:
- Investigated the ability of personalized biomarkers to detect circulating tumor DNA (ctDNA) in postoperative blood specimens of chordoma patients who had detectable ctDNA before surgery.
- Determined if there is a correlation between surgical margins (wide/marginal vs. Intralesional) and the persistence of postoperative ctDNA in these patients.
Research Output:
Principal investigator:
Joost Rutges
Co-Principal investigators:
Daniel Tobert, Joseph Schwab, Jorrit-Jan Verlaan, Harmen Kuijten
Goals:
- Externally validated 10 survival predication models for metastatic spine disease using data from a recent cohort of patients treated with surgery and/or radiotherapy between 2016 and 2021
- Predicted the quality of life (QOL) after treatment using data from prospectively collected QOL questionnaires
- Identified additional prognostic factors using the NOMS framework to improve survival and QOL predictions for new and updated models
- Assessed the optimal trade-off between gains in QOL and extending survival
Research Outputs:
Principal investigator:
Raphaële Charest-Morin
Co-Principal investigators:
Jeremy Reynolds, Gerard Mawhinney
Goals:
To explore lived experiences of people diagnosed with a primary bone tumor using a peer-to-peer support program (spinal Buddy Program (BP)).
The study aims to:
- Implement the BP at two different health centers (Oxford and Vancouver), including necessary training and documentation.
- Evaluate the BP’s impact on patient satisfaction and expectations before and after surgery using both quantitative and qualitative methods.
- Investigate cultural and institutional differences between the two centers.
* This AO Spine-sponsored study is executed with support from the AO Innovation Translation Center (AO ITC) Clinical Evidence.
** Award-winning project
AO Spine KF Tumor Steering Committee
KF Tumor Advisory Board
Charles Fisher
University of British Columbia
Vancouver, BC, Canada
AO Spine Research Commission Past Chairperson 2014–2020
Ziya Gokaslan
The Warren Alpert Medical School of Brown University
Providence, RI, USA
Co-Chairperson/ Chairperson 2011–2014
Laurence Rhines
The University of Texas, MD Anderson Cancer Center
Houston, TX, USA
Co-Chairperson 2020–2023
Riccardo Cecchinato, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Raphaële Charest-Morin, University of British Columbia, Vancouver, BC, Canada
Hanbo Chen, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
Dean Chou, Columbia University Irving Medical Center, New York, NY, USA
Michelle Clarke, Mayo Clinic, Department of Neurologic Surgery, Rochester, MN, USA
Alexander Disch, Universitätsklinikum Cal Gustav Carus, Dresden, Germany
Wietse Eppinga, UMC Utrecht, Utrecht, the Netherlands
Michael Fehlings, University of Toronto, Toronto, ON, Canada
Michael Galgano, University of North Carolina, Department of Neurosurgery, Chapel Hill, NC, USA
Alvaro Silva Gonzalez, University of El Desarrollo, Santiago, Chile
Matthew Goodwin, Washington University, St. Louis, MO, USA
Rory Goodwin, Duke University, Durham, NC, USA Francis Hornicek, University of Miami, Miami, FL, USA
Francis Hornicek, University of Miami, Miami, FL, USA
Mohammed Karim, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Naresh Kumar, National University Hospital, Singapore
Sheng-fu Larry Lo, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
Daniel Lubelski, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Alessandro Luzzati, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Antonio Martin-Benlloch, Hospital Universitario Doctor Peset, Valencia, Spain
Ankit I. Mehta, University of Illinois at Chicago, Chicago, IL, USA
Addisu Mesfin, University of Rochester, Rochester, NY, USA
Jacques Müller-Broich, Orthopedic University Hospital Friedrichsheim, Frankfurt am Main, Germany
Tianyi Niu, Warren Alpert Medical School of Brown University, Providence, RI, USA
Christopher Newman, Memorial Sloan Kettering Cancer Center, New York, NY, USA
John O'Toole, Rush University Medical Center, Chicago, IL, USA
Markian Pahuta, Henry Ford Health System, Detroit, MI, USA
Shalin Patel, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Shreyaskumar Patel, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Kristin Redmond, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Joost Rutges, Erasmus MC, Rotterdam, the Netherlands
Markus Schultheiss, University of Ulm, Ulm, Germany
Joseph Schwab, Massachusetts General Hospital, Boston, MA, USA
Daniel Sciubba, North Shore University Hospital, Northwell Health, Manhasset, NY, USA
John Shin, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Byron Stephens, Vanderbilt University, Nashville, TN, USA
Patricia Sullivan, Rhode Island Hospital/Brown University (part of Warren Alpert Medical School), Providence, RI, USA
Claudio E. Tatsui, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Michael Weber, McGill University, Montreal, QC, Canada
Feng Wei, Peking University Third Hospital, Beijing, China
Josh Yamada, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
Stephen Yip, University of British Columbia, Vancouver, BC Canada
Scott Zuckerman, Vanderbilt University Medical Center, Nashville, TN, USA
Jeremy Kam, Monash Medical Centre, Melbourne, Victoria, Australia
Adam Biczo, National Center for Spinal Disorders, Budapest, Hungary
Gisberto Evangelisti, Istituto Ortopedico Rizzoli, Bologna, Italy
Marcin Czyz, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
Peter Vajkoczy, Charite Universitätsmedizin, Berlin, Germany
Brian Coimba, Universidad De Sao Paulo, Sao Paulo, Brazil
Daniel Tobert, Massachusetts General Hospital, Boston, MA, USA
Jonathan Yang, New York University School of Medecine, New York, NY, USA
Jonathan Tan, National University Hospital, Singapore, Singapore
Marie-Laure Vial
Marie-Laure Vial
Project Manager
Other Knowledge Forums
AO Spine KF Deformity
AO Spine KF Spinal Cord Injury (SCI)
AO Spine KF Degenerative
AO Spine KF Trauma and Infection
“To truly advance care for spine oncology patients, we have developed an international network of spine oncology centers committed to collaborative prospective multicenter research.”
Charles Fisher, AO Spine Research Commission Chairperson