The spine is one of the most common sites for bone metastases from malignant tumors, and its incidence is increasing year by year. It often leads to severe pain, pathological fractures, nerve compression, and spinal cord dysfunction, seriously affecting the quality of life of patients. The comprehensive treatment of spinal metastases with both traditional Chinese and Western medicine has shown significant efficacy, especially in improving clinical symptoms, promoting postoperative recovery as soon as possible, and enhancing the quality of life. Based on the latest research progress at home and abroad and from the perspective of clinical application, this guideline, grounded in evidence-based medical evidence, has formed 25 recommendations covering treatment objectives, efficacy evaluation, rational selection of traditional Chinese medicine, treatment plans, and postoperative rehabilitation. It provides diagnostic and therapeutic suggestions for orthopedic oncologists, oncologists, radiologists, pain specialists, and other professionals engaged in traditional Chinese medicine, Western medicine, or integrated traditional Chinese and Western medicine, as well as specialized nurses.
Lumbar disc herniation (LDH) is one of the most important causes of back and leg pain, which seriously affects the quality of life of patients. As the first-line treatment for LDH, non-operative treatment can relieve 80% to 90% of symptoms among the patients with LDH. This guideline followed Guidelines for the Formulation/Revision of Clinical Treatment Guidelines in China (2022 edition) and WHO handbook for guideline development (2014 edition) to set up guideline working group. This guideline identified fourteen clinical questions through the literature review and clinical experts’ consensus. We drafted the recommendations after systematically searching and evaluating the evidence; delphi method was adopted for expert consensus on the preliminary recommendations, finally, 19 recommendations were made to guide non-operative treatments for LDH. This guideline can provide guidance for the clinical practice of Chinese and western orthopedics practitioners.