The surgical treatment of spinal metastases is controversial.In the first part of the discussion, we thoroughly considered this controversy. The surgical indications in our patients are not based on the prognostic score. The score is only used to decide the best line of treatment when surgery is indicated. The main indications of surgical interventions in our series were neurological compromise and incapacitating pain. These two indications are widely accepted surgical indications in spinal metastases. However, as the life expectancy of patients with tumors is prolonged by the advances in oncologic treatment, surgery in patients with vertebral metastases without neurological deficit or incapacitating pain, was suggested.6A very limited number of patients inour series were treated following this principle(as solitary metastases from thyroid or renal cancers). As we are a well-known specialized center in treatment of spinal tumors, the number of patients with spinal metastases who are candidates for en blocexcision is not rare. Strategy decision is not the only deciding factor for the line of treatment to be used for every patient. After full explanation of his condition, all kinds of treatment options and strategy decision to the patient and his family, their choice is respected, as they have to sign an informed consent.