Surgery insight

Current management of epidural spinal cord compression from metastatic spine disease

Timothy F Witham, Yevgeniy A. Khavkin, Gary L Gallia, Jean Paul Wolinsky, Ziya L. Gokaslan

Research output: Contribution to journalArticle

Abstract

Metastatic epidural spinal cord compression (MESCC) is becoming a more common clinically encountered entity as advancing systemic antineoplastic treatment modalities improve survival in cancer patients. Although treatment of MESCC remains a palliative endeavor, emerging surgical techniques, in combination with imaging modalities that detect spinal metastatic disease at an early stage, are resulting in improved outcomes. Here, we review the clinical presentation, diagnostic work-up and management options in the management of MESCC. A treatment paradigm is outlined with emphasis on early circumferential surgical decompression of the spinal cord with concomitant spinal stabilization. Radiation therapy has a clearly defined role in the treatment of patients with MESCC, particularly those with radiation-sensitive tumors in the setting of non-bony spinal cord compression and those with a limited life expectancy. Spinal stereotactic radiosurgery, vertebroplasty, and kyphoplasty, are emerging treatment options that are beginning to be used in selected patients with MESCC.

Original languageEnglish (US)
Pages (from-to)87-94
Number of pages8
JournalNature Clinical Practice Neurology
Volume2
Issue number2
DOIs
StatePublished - Feb 2006

Fingerprint

Spinal Cord Compression
Spine
Kyphoplasty
Spinal Diseases
Vertebroplasty
Therapeutics
Surgical Decompression
Radiosurgery
Life Expectancy
Antineoplastic Agents
Neoplasms
Spinal Cord
Radiotherapy
Radiation
Survival

Keywords

  • Cancer
  • Metastases
  • Radiation therapy
  • Spinal cord compression
  • Surgery

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Surgery insight : Current management of epidural spinal cord compression from metastatic spine disease. / Witham, Timothy F; Khavkin, Yevgeniy A.; Gallia, Gary L; Wolinsky, Jean Paul; Gokaslan, Ziya L.

In: Nature Clinical Practice Neurology, Vol. 2, No. 2, 02.2006, p. 87-94.

Research output: Contribution to journalArticle

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