In a retrospective study of 172 patients with disseminated carcinoma in the skeleton, 54% were shown by radiography and scintigraphy to have vertebral metastases. Breast carcinoma was the most common primary tumour, occurring in 30% of the patients, followed by lung (17%), prostate (10%) and kidney (9%). The lumbar spine was most often involved and some primary carcinomas showed a predilection for particular spinal segments. Cord compression occurred in 30% of the patients with vertebral spread and was a poor prognostic sign for long-term survival. Hypernephroma was the most common tumour to cause spinal cord involvement. The thoracic segment was the most frequent site of cord compression (43%), and pathological fracture-dislocation was the most common cause (50%).