Do you ever offer spine SBRT for patients with multiple adjacent involved vertebrae?

Yes, multiple spine segments can be treated. NRG 0631 included 2 contiguous spine levels for radiosurgery/SBRT. An earlier study (Ryu et al., PMID 17167762) showed that the spinal cord dose tends to be slightly higher when the length of the target volume is >6cm. This was the basis of including 2 contiguous spine levels on average. Since the spine size varies, this can be viewed as more spine segments in the cervical spines or less in lumbar spines. It may also vary with the height of the person. The effort is to treat the entire vertebral body within the target. With contemporary technical support of intensity modulation and images, longer target, i.e., more contiguous spines, can be treated with the proper clinical decisions.