GSpine4 – Boriani, Stefano


From 1 September 2017 Stefano Boriani has started a new clinical assistance and teaching activity at another IRCSS, the Galeazzi Institute of Milan, in the role of:
Head of Spine Tumor Surgery and Director of the Teaching Programs of the GSpine Division4.

The intense activity in the field of diagnosis and treatment of vertebral tumors has allowed Boriani to develop a Vertebral Tumors Staging System dedicated to the electronic filing of cases and the planning of surgery in relation to the local extension (WBB Staging System). Combined with the Enneking classification of bone tumors allows you to choose the most appropriate treatment.

It is a system widely used in the world, constantly cited in most of the scientific work dedicated to the study and treatment of vertebral tumors.

A second innovation was the proposal of: a system of reconstruction of the vertebral column after oncological excision. It is a modular system in composite material (Carbon Fiber and PEEK) that adapts to each resected segment and allows immediate and long-term stability thanks to the excellent promotion of bone formation within composite cages. This system can be connected with posterior or anterior fixation implants.

Finally, within the international study group of which he was co-chairman and now member of Steering Committee, he collaborated on the development of the SINS (Spine Instability Neoplastic Score), a staging system able to predict the degree of stability or of risk of fracture of a vertebra affected by a neoplasm. The aim of this system is to promote better interaction between the various specialists involved in the multidisciplinary treatment of vertebral neoplasms.

Together with his collaborator Dr. Gasbarrini he developed a Flow-Chart for the treatment of vertebral metastases. It is a therapeutic path based on the local and systemic clinical characteristics of the individual patient, which is thus at the center of the therapeutic choice. A feature of this Flow Chart, which differentiates it from other classifications and stadiations, is to be based on multidisciplinary protocols and collaborations and to be able to gradually adapt to surgical, radiotherapy and oncology advances.

There is a free downloadable App (iSMT) that allows you to follow this path on your smartphone or tablet, thus making the path easy to share.


Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg Am. 1987 Jan;69(1):106-14. PubMed PMID: 3805057.

Boriani S, Weinstein JN, Biagini R. Primary bone tumors of the spine.] Terminology and surgical staging. Spine (Phila Pa 1976). 1997 May 1;22(9):1036-44. Review. PubMed PMID: 9152458.

Fisher CG, DiPaola CP, Ryken TC, Bilsky MH, Shaffrey CI, Berven SH, Harrop JS, Fehlings MG, Boriani S, Chou D, Schmidt MH, Polly DW, Biagini R, Burch S, Dekutoski MB, Ganju A, Gerszten PC, Gokaslan ZL, Groff MW, Liebsch NJ, Mendel E, Okuno SH, Patel S, Rhines LD, Rose PS, Sciubba DM, Sundaresan N, Tomita K, Varga PP, Vialle LR, Vrionis FD, Yamada Y, Fourney DR. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine (Phila Pa 1976). 2010 Oct 15;35(22):E1221-9. doi: 10.1097/BRS.0b013e3181e16ae2. Review. PubMed PMID: 20562730.

Boriani S, Bandiera S, Biagini R, Bacchini P, Boriani L, Cappuccio M, Chevalley F, Gasbarrini A, Picci P, Weinstein JN. Chordoma of the mobile spine: fifty years of experience. Spine (Phila Pa 1976). 2006 Feb 15;31(4):493-503. PubMed PMID: 16481964.

Ibrahim A, Crockard A, Antonietti P, Boriani S, Bünger C, Gasbarrini A, Grejs A, Harms J, Kawahara N, Mazel C, Melcher R, Tomita K. Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007. J Neurosurg Spine. 2008 Mar;8(3):271-8. doi: 10.3171/SPI/2008/8/3/271. PubMed PMID: 18312079.

Fisher CG, Schouten R, Versteeg AL, Boriani S, Varga PP, Rhines LD, Kawahara N, Fourney D, Weir L, Reynolds JJ, Sahgal A, Fehlings MG, Gokaslan ZL. Reliability of the Spinal Instability Neoplastic Score (SINS) among radiation oncologists: an assessment of instability secondary to spinal metastases. Radiat Oncol. 2014 Mar 4;9:69. doi: 10.1186/1748-717X-9-69. PubMed PMID: 24594004;

Boriani S. Expert’s comment concerning Grand Rounds case entitled “Solid aneurysmal bone cyst on the cervical spine of a young child” (L. Casabianca et al.). Eur Spine J. 2015 Jun;24(6):1337-41. doi: 10.1007/s00586-015-3826-0. Epub 2015 Apr 15. PubMed PMID: 25874743.

Bacci G, Toni A, Avella M, Manfrini M, Sudanese A, Ciaroni D, Boriani S, Emiliani E, Campanacci M. Long-term results in 144 localized Ewing’s sarcoma patients treated with combined therapy. Cancer. 1989 Apr 15;63(8):1477-86. PubMed PMID: 2924256.

Boriani S, Bandiera S, Colangeli S, Ghermandi R, Gasbarrini A. En bloc resection of primary tumors of the thoracic spine: indications, planning, morbidity. Neurol Res. 2014 Jun;36(6):566-76. doi: 10.1179/1743132814Y.0000000369. Epub 2014 Apr 13. Review. PubMed PMID: 24725289.

Boriani S, Chevalley F, Weinstein JN, Biagini R, Campanacci L, De Iure F, Piccill P. Chordoma of the spine above the sacrum. Treatment and outcome in 21 cases. Spine (Phila Pa 1976). 1996 Jul 1;21(13):1569-77. PubMed PMID: 8817786.