Stereotactic Body Radiation Therapy and Vertebroplasty in Treating Patients With Localized Spinal Metastasis

Eligibility: Inclusion: * Patients must have localized spine metastasis (a solitary spine metastasis; two contiguous levels, or up to three separate single vertebral levels are permitted) * Patients must have a VAS of ≥4 at any of the planned treatment sites * Patient with epidural, spinal nerve, and/or cord compression on MRI may be included * Histologic confirmation of cancer is required by biopsy, prior surgery, or re-biopsy * Narcotic pain prescription and usage information must be available and documented * Patients must sign study specific consent * Above the age of 18 * For women of childbearing age a negative pregnancy test is required * Patients considered for the retreatment arm, must not of had prior radiation to the proposed spinal site within a 3 month interval prior to treatment * Zubrod score of 0-2 Exclusion: * Patients who have been non-ambulatory for more than 7 days * Patients with compression fractures * Spine instability requiring fixation * Patients with paraspinal extension * Patients with bony fragments * Planned systemic treatment within one week after treatment. * Absence of pathological diagnosis of cancer * Chemotherapy within one week of treatment * Patients with Multiple Myeloma, Lymphoma, or Plasmacytoma * Patient suffered from unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months * Patient had a transmural myocardial infarction within the last 6 months * Patient has an acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration * Patient has hepatic insufficiency resulting in clinical jaundice and/or coagulation defects * PT is not within normal limits or planned and feasible to be corrected to normal limits prior to vertebroplasy * PTT is not within normal limits or planned and feasible to be corrected to normal limits prior to vertebroplasy * Platelet count is \< 50,000 * History of significant psychiatric illness Note: Vertebroplasty may not be possible for certain patients due to tumor location or safety. In such cases, patients will omit the vertebroplasty but receive all other protocol care and follow-up Visual Analog Scoring