Inclusion Criteria: - Histologically confirmed primary tumor or metastatic cancer with radiological diagnosis of spine metastasis - The patient must have localized spine metastasis from the C1 to L5 levels by a screening imaging study - Zubrod Performance Status 0-2 - History/physical examination within 2 weeks prior to registration - Negative pregnancy test within 2 weeks prior to registration for women of childbearing potential - Women of childbearing potential and male participants who are sexually active must agree to use a medically effective contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. - MRI of the involved spine within 4 weeks prior to registration to determine the extent of the spine involvement - Numerical Rating Pain Scale within 1 week prior to registration; the patient must have a score on the Scale of >5 for at least one of the planned sites for spine radiosurgery. Patients taking medication for pain at the time of registration are eligible. - Neurological examination within 1 week prior to registration to rule out rapid neurologic decline Exclusion Criteria: - Histology of myeloma, lymphoma or germ cell tumors. - Non-ambulatory patients - Spine instability due to a compression fracture - > 50% loss of vertebral body height - Frank spinal cord displacement or epidural involvement with> 25% encirclement of cord or >25% spinal canal involvement. - Prior radiation to the index spine - Patients for whom an MRI of the spine is medically contraindicated - Uncontrolled intercurrent illness