 Hi, I am Dr. Vidyadara here, Head of the Department and Concertant Fine Surgeon at Manipal Hospital, Bangalore. Final tumors are quite common. Definitely in a tertiary care centre like that of ours, the Manipal Fine Care Centre, definitely we encounter a huge number of final tumors. The most common being the metastatic tumors in elderly people. Any back pain, which is significant, needs to be evaluated for final metastatic tumor. And also, at times we come across patients with multiple myeloma which can present with problems or tumors in the spine, or rarely a primary tumor in the bone like Gensel tumor or any regional bone disease is also prevalent. Now the common is being metastatic spinal tumors, they all come with back pain. When you do X-rays and MRIs, already one of the other bone could have fractured because of the pathology which has weakened the bone. And it is not because of the injury that the patient has broken the bone, it is just because the bone has been weakened by the disease or the cancer. In these conditions, what we do is very systematic. First, we need to work up and make sure that whether we can get the primary tumor, like PET CT scan is the ideal before you head for any other intervention, and also sometimes blood test can get us to be diagnosed. Once the diagnosis is confirmed, the back pain because of which the patient has been non-ambulance can be treated very well with minimal invasive procedures such as vertebroplasty or balloon typhoplasty, which are daycare procedures wherein we insert a needle into the fractured bone and take a biopsy from the tissue in the bone, the back bone, and then inject bone cement into the bone of the back. And once the bone cement sets, the patient becomes pain free to the extent of 75 to 95% and we can again be ambulance and once the biopsy report comes, we can get treated by the oncologist appropriately with either chemotherapy or radiotherapy. And second common is being myeloma, multiple myeloma, which is also the predominant site of spines, can be treated with chemotherapy once diagnosed. And the rare tumors, we may have to go more aggressive like dental tumor, we may have to do anterior posterior surgery with complete accession of the tumor.