Treatment of Metastatic Spinal Epidural Disease: Surgery Versus Radiotherapy

  • Chester K. Yarbrough
  • Wilson Z. Ray
  • Meic H. Schmidt
Part of the Tumors of the Central Nervous System book series (TCNS, volume 10)


Metastatic spinal disease occurs frequently, affecting as many as 40% of cancer patients over time. Approximately 10% of these patients experience malignant epidural spinal cord compression. Metastasis to the spine causes significant morbidity and often leads an inexorable decline into paraplegia and loss of bowel and bladder function. Advances in surgical techniques have allowed a more aggressive approach to treatments for cytoreduction and spinal stabilization. Fractionated radiotherapy has proved effective in treatment of these patients, but inability to design and implement highly conformal plans initially limited the use of radiation delivery until the development of stereotactic and highly conformal radiation delivery techniques. The current data supporting surgery and radiation for treatment of metastatic spinal disease will be reviewed in this chapter.


Spinal Metastasis Vertebral Column Resection Metastatic Spinal Disease Epidural Metastasis Conformal Treatment Planning 
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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Chester K. Yarbrough
    • 2
  • Wilson Z. Ray
    • 1
  • Meic H. Schmidt
    • 1
  1. 1.Department of NeurosurgeryUniversity of Utah, Clinical Neurosciences CenterSalt Lake CityUSA
  2. 2.Department of NeurosurgeryWashington UniversitySt. LouisUSA

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