Surgical treatment of vertebral metastases.

Metastatic tumors often spread to the vertebral column. When the mechanical strength of a vertebra is decreased as a result of tumor-induced bone destruction, a pathologic fracture may occur. Such a fracture is often associated with severe pain. If it occurs in the thoracic or upper lumbar region, there is a major risk of paraplegia if the fractured vertebral body is displaced into the spinal canal. Metastases in the vertebral column also can cause neurologic symptoms due to direct infiltration of the tumor into the spinal canal. Due to recent advances in spinal surgery, effective help often can be provided to these patients. The extent and type of surgical intervention, however, must be carefully considered in each individual case.