Abstract
Each year, 1.3 million new cancers are diagnosed in the United States (2). Carcinomas of the lung, breast, prostate, and kidney are the most common (3–5). More than 70% of these patients will develop skeletal metastases, most commonly in the spine (6). Primary malignancies of the spine are not rare, but in adults, the vast majority of spine lesions represent lymphatic or hematogenous metastasis (7).
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References
McCulloch JA, Transfeldt EE. MacNab’s Backache. 3d Ed. Baltimore, MD: Williams and Wilkings; 1997:257–276.
Landis SH, Murray T, Bolden S, Wingo PA. Cancer Statistics, 1998. CA Cancer J Clin 1998; 48:6–29.
Frassica FJ, Gitelis S, Sim FH. Metastatic bone disease: general principles, pathophysiology, evaluation, and biopsy. Instr Course Lect 1992; 41:293–300.
Frassica FJ, Sim FH. Pathogenesis and prognosis. In: Sim FH, ed. Diagnosis and Management of Metastatic Bone Disease. A Multidisciplinary Approach. New York, NY: Raven Press; 1988:1–6.
Frassica FJ, Sim FH. Bone Pain. In: Taylor R, ed. Difficult Diagnoses II. Philadelphia, PA: WB Saunders; 1992, pp. 52–54.
Harrington KD. Metastatic disease of the spine. J Bone Joint Surg Am 1986; 68:1110–1115.
Dahlin DC. Bone Tumors. General Aspects and Data on 6,221 Cases. 3rd ed. Springfield, IL: Thomas; 1978.
Weinstein JN, McLain RF. Primary tumors of the spine. Spine 1987; 12:843–851.
Leeson MC, Makley JT, Carter JR. Metastatic skeletal disease in the pediatric population. J Pediatr Orthop 1985; 5:261–267.
Young J, Miller R. Incidence of malignant tumors in U.S. children. J Pediatr 1975; 1:254–258.
Parham DM, Pratt CB, Parvey LS, Webber BL, Champion J. Childhood multifocal osteosarcoma. Clinicalpathologic and radiographic correlates. Cancer 1985; 55:2653–2658.
Fraser RD, Paterson DC, Simpson DA. Orthopaedic aspects of spinal tumours in children. J Bone Joint Surg Br 1977; 59:143–151.
Boriani S, Weinstein JN. Differential diagnosis and surgical treatment of primary benign and malignant neoplasms. In: Frymoyer JW, ed. The Adult Spine. Principles and Practice. 2nd ed. Philadelphia, PA: Lippincott-Raven; 1997:951–987.
Pedersen AG, Bach F, Melgaard B. Frequency, diagnosis, and prognosis of spinal cord compression in small cell bronchogenic carcinoma. A review of 817 consecutive patients. Cancer 1985; 55:1818–1822.
Koskinen EV, Nieminen RA. Surgical treatment of metastatic pathologic fracture of major long bones. Acta Orthop Scand 1973; 44:539–549.
Kostuik JP. Differential diagnosis and surgical treatment of metastatic spine tumors. In: Frymoyer JW, ed. The Adult Spine. Principles and Practice. 2nd ed. Philadelphia, PA: Lippincott-Raven; 1997:989–1014.
Burger EL, Lindeque BG. Sacral and non-spinal tumors presenting as backache. A retrospective study of 17 patients. Acta Orthop Scand 1994; 65:344–346.
Batson OV. The function of the vertebral veins and their role in the spread of metastases. Ann Surg 1940; 112:138–149.
Bohlman HH, Sachs BL, Carter JR, Riley L, Robinson RA. Primary neoplasms of the cervical spine. J Bone Joint Surg Am 1986; 68:483–494.
Ruff RL, Lanska DJ. Epidural metastases in prospectively evaluated veterans with cancer and back pain. Cancer 1989; 63:2234–2241.
Van den Hoogen HM, Koes BW, van Eijk JT, Bouter LM. On the accuracy of history, physical examination, and erythrocyte sedimentation rate in diagnosing low back pain in general practice. A criteria-based review of the literature. Spine 1995; 20:318–327.
Rougraff BT, Kneisl JS, Simon MA. Skeletal metastases of unknown origin: a prospective study of a diagnostic strategy. J Bone Joint Surg 1993; 75:1276–1281.
McLain RF. Tumors of the spine. In: Chapman MW: Chapman’s Orthopaedic Surgery. 3rd ed. Philadelphia, PA: Lippincott William and Wilkins; 2001:3933–3958.
Boland PJ, Lane JM, Sundaresan N. Metastatic disease of the spine. Clin Orthop 1982; 169:95–102.
Siegal T, Siegal T. Current considerations in the management of neoplastic spinal cord compression. Spine 1988; 14:223–228.
Hall TC, Griffiths CT, Petranek JR. Hypercalcemia. An unusual metabolic complication of breast cancer. N Engl J Med 1966; 275:1474–1477.
Helweg-Larsen S, Sorenson PS. Symptoms and signs in metastatic cord compression. A study of progression from first symptom until diagnosis in 153 patients. Eur J Cancer 1994; 30A:396–398.
Gilbert RW, Kim JH, Posner JB. Epidural spinal cord compression from metastatic tumor. Diagnosis and treatment. Ann Neurol 1978; 3:40–51.
Shives TC, Dahlin DC, Sim FH, Pritchard DJ, Earle JD. Osteosarcoma of the spine. J Bone Joint Surg Am 1986; 68:660–668.
Thommesen P, Poulson JO. Primary tumors in the spine and pelvis in adolescents, Clinical and radiologic features. Acta Orthop Scand 1976; 47:170–174.
Sim FH, Dahlin DC, Stauffer RN, Laws ER. Primary bone tumors simulating lumbar disc syndrome. Spine 1977; 2:65–74.
Sim FH, Frassica FJ, Edmonson JH. Spine. In: Sim, FH, ed. Diagnosis and Management of Metastatic Bone Disease. A Multidisciplinary Approach. New York, NY: Raven Press; 1988, pp. 45–49.
Weinstein JN, Boriani S, Campanaci L. Spine neoplasms. In: Weinstein, SL ed. The Pediatric Spine. Principles and Practice. Philadelphia, PA: Lippincott Williams and Wilkins; 2001:685–707.
Freiberg AA, Graziano GP, Loder RT, Hensinger RN. Metastatic vertebral disease in children. J Pediatr Orthop 1993; 13:148–153.
Rogalsky RJ, Black GB, Reed MH. Orthopaedic manifestations of leukemia in children. J Bone Joint Surg Am 1986; 68:494–501.
Marchesi DG, Boos N, Aebi M. Surgical treatment of tumors of the cervical spine and first two thoracic vertebrae. J Spinal Disord 1993; 6:489–496.
Kujawa KA, Niemi VR, Tomasi MA, Mayer NW, Cochran E, Goetz CG. Ballistic-choreic movements as the presenting feature of renal cancer. Arch Neurol 2001; 58:1133–1135.
Bollanti L, Riondino G, Strollo F. Endocrine paraneoplastic syndromes with special reference to the elderly. Endocrine 2001; 14:151–157.
Mitnick HJ. Paraneoplastic rheumatic syndromes. Curr Rheumatol Rep 2000; 2:163–170.
Brenner S, Tamir E, Maharshak N, Shapira J. Cutaneous manifestations of internal malignancies. Clin Dermatol 2001; 19:290–297.
Vielhauer V, Herzinger T, Korting HC. The sign of Leser-Trelat: a paraneoplastic cutaneous syndrome that facilitates early diagnosis of occult cancer. Eur J Med Res 2000; 5:512–516.
Jolobe OM. Neurological manifestations of malignant disease. Hosp Med 2000; 61:675.
Rudnicki SA, Dalmau J. Paraneoplastic syndromes of the spinal cord, nerve, and muscle. Muscle Nerve 2000; 23:1800–1818.
Bradwell AR. Paraneoplastic neurological syndromes associated with Yo, Hu, and Ri autoantibodies. Clin Rev Allergy Immunol 2000; 19:19–29.
Vigliani MC, Palmucci L, Polo P, et al. Paraneoplastic opsoclonusmyoclonus associated with renal cell carcinoma and responsive to tumour ablation. J Neurol Neurosurg Psychiatry 2001; 70:814–815.
Pranzatelli MR. Paraneoplastic syndromes: an unsolved murder. Semin Pediatr Neurol 2000; 7:118–130.
Carpentier AF, Delattre JY. The Lambert-Eaton myasthenic syndrome. Clin Rev Allergy Immunol 2001; 20:155–158.
Thompson JT, Paschold EH, Levine EA. Paraneoplastic hypercalcemia in a patient with adenosquamous cancer of the colon. Am Surg 2001; 67:585–588.
Wong DA, Fornasier VL, MacNab I. Spinal metastases: the obvious, the occult, and the impostors. Spine 1990; 15:1–4.
Mirra JM. Metastases. In: Mirra JM, ed. Bone Tumors. Philadelphia, PA: Lea and Febiger; 1986:1499–1450.
Enzinger FM, Weiss SW., eds. Soft Tissue Tumors. St. Louis, MO: C. V. Mosby; 1983.
Bell RM. Thyroid Carcinoma. Surg Clin North Am 1986; 66:13–30.
Leeper RD. Thyroid Cancer. Med Clin North Am 1985; 69:1079–1096.
Barkin JS, Goldstein JA. Diagnostic approach to pancreatic cancer. Gastroenterol Clin North Am 1999; 28:709–722, xi.
Perilongo G, Shafford EA. Liver tumours. Eur J Cancer 1999; 35:953–958.
Kiely JM. Hypernephroma. The internist’s tumor. Med Clin North Am 1966; 50:1067–1083.
Seidel HM, Ball JW, Dains JE, Benedict GW. Mosby’s Guide to Physical Examination. St. Louis, MO: CV Mosby; 1987.
Cumming J, Hacking N, Fairhurst J, Ackery D, Jenkins JD. Distribution of bony metastases in prostatic carcinoma. Br J Urol 1990; 66:411–414.
Asdourian PL, Weidenbaum M, DeWald RL, Hammerberg KW, Ramsey RG. The pattern of vertebral involvement in metastatic vertebral breast cancer. Clin Orthop 1990; (250):164–170.
King HA. Back pain in children. In: Weinstein, SL, ed. The Pediatric Spine. Principles and Practice. Philadelphia, PA: Lippincott Williams and Wilkins; 2001:685–707.
King HA. Back pain in children. Orthop Clin North Am 1999; 30:467–474, ix.
Keim HA, Reina EG. Osteoid-Osteoma as a cause of scoliosis. J Bone Joint Surg Am 1975; 57:159–163.
Khuffash B, Porter RW. Cross leg pain and trunk list. Spine 1989; 14:602–603.
Klein JD, Garfin SR. Clinical evaluation of patients with suspected spine problems. In: Frymoyer JW, ed. The adult spine. Principles and Practice. 2nd ed. Philadelphia, PA: Lippincott-Raven; 1997:319–340.
Abdu WA, Provencher M. Primary bone and metastatic tumors of the cervical spine. Spine 1998; 23:2767–2777.
Bos GD, Ebersold MJ, McLeod RA, et al. Lesions of the spine. In: Sim FH, ed. Diagnosis and Management of Metastatic Bone Disease. A Multidisciplinary Approach. New York, NY: Raven Press; 1988:221–236.
Greene WB, Heckman JD. Clinical Measurement of Joint Motion. Chicago, IL: American Academy of Orthopaedic Surgeons; 1994.
Spurling RG. Lesions of the Cervical Intervertebral Disc. Springfield, IL: Thomas; 1956.
Davidson R, Dunn E, Metzmaker J. The shoulder abduction test in the diagnosis of radicular pain in cervical extradural compressive monoradiculopathies. Spine 1981; 6:441–446.
Thelander U. Straight leg raising versus radiologic size, shape and position of lumbar disc hernias. Spine 1992; 17:395–398.
Schofferman JA. Physical examination. In: White AH, ed. Spine Care. St. Louis, MO: Mosby-Year Book; 1995:71–81.
Christodoulides AN. Ipsilateral sciatica on femoral nerve stretch test is pathognomonic of an L4-5 disc protrusion. J Bone Joint Surg 1989; 71B:88–89.
Bickels J, Kahanovitz N, Rubert CK, et al. Extraspinal bone and soft-tissue tumors as a cause of sciatica. Clinical diagnosis and recommendations: analysis of 32 cases. Spine 1999; 24:1611–1616.
Hoppenfeld S. Physical Examination of the Spine and Extremities. Norwalk, CT: Appleton and Lange; 1976.
McCombe PF. Reproducibility of physical signs in low back pain. Spine 1989; 14:909–918.
Ono K, Ebara S, Fuji T, Yonenobu K, Fujiwara K, Yamashita K. Myelopathy hand. J Bone Joint Surg 1987; 69:215–219.
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Truumees, E. (2006). Physical Examination. In: McLain, R.F., Lewandrowski, KU., Markman, M., Bukowski, R.M., Macklis, R., Benzel, E.C. (eds) Cancer in the Spine. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59259-971-4_8
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