Vertebroplasty With Radiation Therapy for Spine Metastatic Cancer Patients With Indeterminate Lesion (SINS Criteria)

Inclusion Criteria: * At least 18 years of age and older with indeterminate Spine Metastasis. * All patients with histology that requires stereotactic RT as a part of their treatment. * Eastern Cooperative Oncology Group (ECOG) performance status =\< 2 * Disease visualized by CT or MRI * Prior radiation therapy will be allowed at the discretion of the Radiation Oncologist based on current standard operating procedures. * Tumor tissue from the core biopsy or resected site of disease will be collected, if available for biomarker analyses. * Four or less consecutive spinal segments involved by tumor. Or four or less separate spinal tumor targets with a minimum of one vertebral body separation * Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life questionnaire in either English or Spanish. The baseline assessment must be completed within required timelines. Inability (illiteracy in English or Spanish, loss of sight, or other equivalent reason) to complete the questionnaires will not make the patient ineligible for the study. However, ability but unwillingness to complete the questionnaires will make the patient ineligible Exclusion Criteria: * Patients \< 18 years of age * Inability to get a standard MRI or CT myelogram for radiation treatment target delineation * Patients with prior radiation to the spinal segment to be treated may be included if the radiation dose can be delivered safely, per the treating radiation oncologist. * Patients with symptomatic spinal cord compression requiring emergent surgery * Pregnant or lactating women * Systemic therapy or immunosuppressive medications, excluding immunotherapy, within 3-14 days of radiation treatment, at the discretion of the treating radiation oncologist . * Patients with stable or unstable lesions based on SINS criteria