Outcomes, Quality of Life, and Value in Cervical Spine Oncology: Neurological Recovery, Patient-Reported Outcomes, and Prognostic Decision-Making.

STUDY DESIGN: Narrative review. OBJECTIVE: To provide an overview of outcomes, cost-effectiveness, local control, survivorship, and prognostic decision-making in cervical spine oncology. SUMMARY OF BACKGROUND DATA: Cervical spine oncology includes both metastatic and primary tumors, each with distinct treatment goals and oncologic considerations. Cervical spine tumors can impair quality of life through pain, neurological deficits, and mechanical instability. METHODS: This review synthesizes current literature on neurological and functional outcomes, health-related quality of life (HRQOL), cost-effectiveness, local control, survivorship, and prognostic decision-making in cervical spine oncology. RESULTS: Prospective multicenter studies demonstrate significant improvements in pain, neurological function, and HRQOL after surgery for metastatic cervical spine disease. Separation surgery followed by stereotactic body radiotherapy (SBRT) achieves high rates of local control in appropriately selected patients. Cost-effectiveness is greatest among patients with acute neurological compromise and favorable survival prognoses. We additionally review prognostic classification systems, machine-learning algorithms, and outcomes in primary cervical spine tumors including cervical chordoma. CONCLUSIONS: Cervical spine oncology requires individualized multidisciplinary treatment. Prospective outcomes data, validated patient-reported outcome instruments, modern radiation strategies, and prognostic algorithms support contemporary decision-making in patients with cervical spine tumors.