As mentioned previously, the optimal management of individuals with metastatic spine lesions remains an area of active research. Historically, the standard of care for symptomatic lesions consisted of early radiation therapy along with corticosteroids. In many individuals, this strategy reliably improves pain and prevents neurologic decline in the short term. However, some individuals have better overall prognosis while some lesions are resistant to radiotherapy. In these circumstances, surgical interventions are usually performed. Various groups have studied the efficacy of various treatment approaches. Table 9 summarizes some of the existing literature in this area which aims to determine the utility and cost-effectiveness of decompressive surgery along with varying radiotherapy regimens.