Evaluation and treatment of spinal metastases: an overview

Neurosurg Focus. 2001 Dec 15;11(6):e10. doi: 10.3171/foc.2001.11.6.11.

Abstract

Metastases to the spine are a common and somber manifestation of systemic neoplasia. The incidence of spinal metastases continues to increase, likely a result of increasing survival times for patients with cancer. Historically, surgery for spinal metastases has consisted of simple decompressive laminectomy. Results obtained in retrospective case series, however, have shown that this treatment provides little benefit to the patient. With the advent of better patient-related selection practices, in conjunction with new surgical techniques and improved postoperative care, the ability of surgical therapy to play an important and beneficial role in the multidisciplinary care of cancer patients with spinal disease has improved significantly. Controversy remains, however, with respect to the relative merits of surgery, radiotherapy, chemotherapy, or a combination of these treatments. In this topic review, the literature on spinal column and spinal cord metastases is collated to provide a description of the presentation, investigations, indications for surgical therapy, and the role of adjuvant cancer therapies for patients with spinal metastases. In addition, the authors discuss the different surgical strategies available in the armamentarium of the neurosurgeon treating patients with spinal metastasis.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Case Management
  • Decompression, Surgical
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Diagnostic Tests, Routine
  • Embolization, Therapeutic
  • Humans
  • Incidence
  • Internal Fixators
  • Laminectomy
  • Neurosurgical Procedures
  • Orthopedic Procedures
  • Preoperative Care
  • Radiotherapy / adverse effects
  • Radiotherapy / methods
  • Spinal Cord Compression / drug therapy
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / radiotherapy
  • Spinal Cord Compression / surgery
  • Spinal Neoplasms / classification
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / diagnosis
  • Spinal Neoplasms / epidemiology
  • Spinal Neoplasms / physiopathology
  • Spinal Neoplasms / secondary*
  • Spinal Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones