Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on April 30, 2024.LEARNING OBJECTIVES: After participating in this continuing professional development activity, the spine surgeon should be better able to: 1. Describe surgical management of symptomatic metastatic spinal lesions. 2. Interpret the current literature on bone graft and bone graft substitution options used in metastatic spine surgery. 3. Explain the advantages and disadvantages of various options in bone grafts and substitutions.