Stereotactic Spine Radiosurgery (SRS)

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Stereotactic radiosurgery of the spine (SRS) is an innovative, noninvasive treatment option for both malignant and benign spine tumors. Stereotactic spine radiosurgery can provide pain relief through a non-invasive, non-surgical procedure that delivers precise radiation to the tumor using a three-dimensional targeting system. This is frequently the preferred treatment for spine tumors, and it can also be a component of an integrated treatment plan.

Diseases treated with Stereotactic Spine Radiosurgery

Spine radiosurgery can be used to treat benign or malignant spine lesions, such as:

  • Primary cancers
  • Metastases
  • Meningiomas
  • Neurofibromas
  • Schwannomas
  • Vascular malformations

Tumors of the spine can develop in the bones, nerves, and other tissues that comprise the spinal column and cord. They can be benign (noncancerous), low-grade malignant (cancerous) tumors that grow slowly, or high-grade malignant (cancerous) tumors that grow aggressively. More than ninety percent of spine tumors are metastatic, meaning they originate in a different part of the body and can cause painful symptoms necessitating invasive treatment.

Types of Stereotactic Spine Radiosurgery

Stereotactic spine radiosurgery implies two types of technology to deliver radiation:

Linear accelerator (LINAC) machines use X-rays (photons) to treat cancerous and noncancerous brain and body abnormalities. LINAC machines are also known by their manufacturer’s brand names, including CyberKnife and TrueBeam. These machines are capable of performing stereotactic radiosurgery (SRS) in a single session or over three to five sessions for larger tumors, a procedure known as fractionated stereotactic radiotherapy.

Preparation for Stereotactic Spine Radiosurgery

The preparation for stereotactic body radiotherapy varies based on the treated condition and body region. You may be instructed to fast for two to three hours before a procedure. There may be specific recommendations regarding medication intake.

Wear loose, comfortable clothing. You may be asked to remove your jewelry, eyewear, contact lenses, or dentures. If you have medical devices inside your body, you should always inform your healthcare team. These may consist of a pacemaker, an artificial heart valve, aneurysm clips, neurostimulators, or stents.

Before beginning stereotactic body radiotherapy, your medical team follows a series of procedures, such as:

  • Positioning. To precisely administer treatment, the patient must remain perfectly still. Your medical team will determine the optimal position for your body. Typically, this requires the use of custom-made devices to hold you in place and ensure your comfort.
  • Marking. Markers help target treatment. Frequently, tattoos on the skin mark the area for subsequent treatments. Occasionally, it is required to place a small metal marker, known as a fiducial marker, within or near the tumor. The fiducial marker is approximately the size of a rice grain.
  • Imaging. Once you are in position, imaging scans provide information about your tumor’s location, size, and shape. A scan can also reveal how the tumor moves during respiration. Occasionally, the collected data may indicate that you must hold your breath for 10 to 30 seconds at a time during treatment to keep the tumor still.
  • Planning. Using imaging scans and specialized software, your health care team determines the optimal treatment approach.


The stereotactic radiosurgery treatment group consists of experienced neurosurgeons, radiation oncologists, and medical physicists who collaborate closely to provide each patient with the most effective treatment possible. Children may be administered medication to induce a sleep-like state during the procedure. Typically, adults do not require this medication. If you are extremely anxious about your treatment, you may be given medication to help you relax.

Stereotactic radiosurgery is painless. During the procedure, you will be able to speak with a member of your health care team. 

The specialized equipment concentrates numerous radiation beams on a tumor or another target. Each beam has a minimal effect on the tissue it traverses, but a targeted dose of radiation is delivered to the intersection point. The high dose of radiation delivered to the affected area causes tumors to shrink and blood vessels to close, depriving the tumor of its blood supply over time.

Thanks to the accuracy of stereotactic radiosurgery, there is minimal collateral damage to healthy surrounding tissues. In most instances, radiosurgery carries a lower risk of side effects than conventional surgery or radiation therapy.

A stereotactic radiosurgery treatment can last approximately an hour. Following the procedure, you can ask for medications to treat your symptoms, such as a temporary increase in pain or nausea.  You will be able to consume food and liquids after the procedure. Typically, you may return home on the same day and you can resume normal activities within two days.

After your stereotactic spine radiosurgery, your neurosurgeon or radiation oncologist will schedule an MRI scan and a follow-up appointment. Depending on your condition, you may require routine follow-up appointments and imaging studies at regular intervals.

Benefits of Stereotactic Spine Radiosurgery

The stereotactic radiosurgery of the spine requires almost no recuperation time. It frequently results in rapid pain relief, which can significantly enhance functional capacity. Among the advantages of spine radiosurgery are:

  • No incision
  • Outpatient procedure
  • Bloodless
  • Rapid restoration
  • Excellent chronic pain and tumor management


Over time, the effects of stereotactic radiotherapy treatment manifest. Noncancerous tumors, known as benign tumors, may require 18 months to two years to shrink. The primary objective of treatment for benign tumors is to prevent tumor growth. Malignant tumors may shrink more rapidly, perhaps within a few months.