Skip to main content

Advertisement

SpringerLink
Log in

Metastasis to nervous system: spinal epidural and intramedullary metastases

  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Summary

Spinal cord epidural metastasis (SEM) is a common complication of systemic cancer with an increasing incidence. Prostate, breast and lung cancer are the most common offenders. Metastasis usually arises in the posterior aspect of vertebral body with later invasion of epidural space. Pathophysiologically, vascular insufficiency is more important than direct spinal cord compression. The most common complaint is pain, and two thirds of patients with SEM have motor signs at initial diagnosis. Currently magnetic resonance imaging is the most sensitive diagnostic tool. The optimal management of SEM is still arguable, but recent advances in surgical management of SEM and higher complication rate of surgery following radiotherapy should persuade clinicians to consider de novo surgery where possible. Radiotherapy has an important role, particularly in treatment of radiosensitive tumors and in patients who are not candidates for surgery. Novel approaches such as stereotactic radiosurgery are promising; however, response to chemotherapy depends on inherent properties of primary tumor. Recurrent SEM is a substantial problem for which surgery or repeat radiotherapy may be options. Intramedullary metastasis is rare but should be considered in patients with systemic malignancy and asymmetrical presentation of myelopathic symptoms. The prognosis is usually poor and preferred modality of treatment is radiotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. D Schiff (2003) ArticleTitleSpinal cord compression Neurol Clin N Am 21 67–87 Occurrence Handle10.1016/S0733-8619(02)00033-6

    Article  Google Scholar 

  2. RY Kim (1990) ArticleTitleExtradural spinal cord compression from metastatic tumor Ala Med 60 10–15 Occurrence Handle2239623

    PubMed  Google Scholar 

  3. F Bach BH Larsen K Rohde SE Borgesen F Gjerris T Boge-Rasmussen N Agerlin B Rasmusson P Stjernholm PS Sorensen (1990) ArticleTitleMetastatic spinal cord compression Occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression. Acta Neurochir (Wien) 107 37–43

    Google Scholar 

  4. JWW Coebergh M Sant F Berrino A Verdecchia (1998) ArticleTitleGuest Eds. Survival of adult cancer patients in Europe diagnosed from 1978–1989: special issue Eur J Cancer 34 2137–2278 Occurrence Handle10.1016/S0959-8049(98)99063-3

    Article  Google Scholar 

  5. DA Loblaw NJ Laperriere WJ Mackillop (2003) ArticleTitleA population-based study of malignant spinal cord compression in ontario Clinical Oncology 15 211–217 Occurrence Handle10.1016/S0936-6555(02)00400-4 Occurrence Handle12846501

    Article  PubMed  Google Scholar 

  6. E Maranzano P Latini (1995) ArticleTitleEffectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial Int J Radiat Oncol Biol Phys 32 959–967 Occurrence Handle10.1016/0360-3016(95)00572-G Occurrence Handle7607970

    Article  PubMed  Google Scholar 

  7. LD Rodichok JC Ruckdeschel GR Harper G Cooper L Prevosti L Fernando DH Baxter (1986) ArticleTitleEarly detection and treatment of spinal epidural metastases: the role of myelography Ann Neurol 20 696–702 Occurrence Handle10.1002/ana.410200608 Occurrence Handle2949691

    Article  PubMed  Google Scholar 

  8. GR Harper LD Rodichok L Prevosti et al. (1982) ArticleTitleEarly diagnosis of spinal epidural metastases leads to improved treatment outcome Proc Am Soc Clin Oncol 1 6

    Google Scholar 

  9. S Helweg-Larsen SW Hansen PS Sorensen (1995) ArticleTitleSecond occurrence of symptomatic metastatic spinal cord compression and findings of multiple spinal epidural metastases Int J Radiat Oncol Biol Phys 33 595–598 Occurrence Handle10.1016/0360-3016(95)00199-9 Occurrence Handle7558948

    Article  PubMed  Google Scholar 

  10. E Maranzano P Latini F Checcaglini S Ricci BM Panizza C Aristei E Perrucci S Beneventi E Corgna M Tonato (1991) ArticleTitleRadiation therapy in metastatic spinal cord compression. A prospective analysis of 105 consecutive patients Cancer 67 1311–1317 Occurrence Handle1991293

    PubMed  Google Scholar 

  11. D O'Neill BP Schiff VJ Suman (1997) ArticleTitleSpinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach Neurology 49 452–456 Occurrence Handle9270576

    PubMed  Google Scholar 

  12. DA Wong VL Fornasier I MacNab (1990) ArticleTitleSpinal metastases: the obvious, the occult, and the impostors Spine 15 1–4 Occurrence Handle2326692

    PubMed  Google Scholar 

  13. SL Klein RA Sanford MS Muhlbauer (1991) ArticleTitlePediatric spinal epidural metastases J Neurosurg. 74 70–75 Occurrence Handle1845814

    PubMed  Google Scholar 

  14. E Bouffet P Marec-Berard P Thiesse C Carrie T Risk A Jouvet M Brunat-Mentigny C Mottolese (1997) ArticleTitleSpinal cord compression by secondary epi- and intradural metastases in childhood Childs Nerv Syst 13 383–387 Occurrence Handle10.1007/s003810050105 Occurrence Handle9298274

    Article  PubMed  Google Scholar 

  15. FL Ampil (1989) ArticleTitleEpidural compression from metastatic tumor with resultant paralysis J Neurooncol 7 129–136 Occurrence Handle10.1007/BF00165097 Occurrence Handle2778489

    Article  PubMed  Google Scholar 

  16. D Parsch R Mikut R Abel (2003) ArticleTitlePostacute management of patients with spinal cord injury due to metastatic tumour disease: survival and efficacy of rehabilitation Spinal Cord 41 205–210 Occurrence Handle10.1038/sj.sc.3101426 Occurrence Handle12669084

    Article  PubMed  Google Scholar 

  17. E Maranzano P Latini S Beneventi L Marafioti F Piro E Perrucci M Lupattelli (1998) ArticleTitleComparison of two different radiotherapy schedules for spinal cord compression in prostate cancer Tumori 84 472–477 Occurrence Handle9824999

    PubMed  Google Scholar 

  18. PR Algra JJ Heimans J Valk JJ Nauta M Lachniet B Van Kooten ParticleVan (1992) ArticleTitleDo metastases in vertebrae begin in the body or the pedicles Imaging study in 45 patients. AJR Am J Roentgenol 158 1275–1279

    Google Scholar 

  19. FM Khaw SA Worthy MJ Gibson A Gholkar (1999) ArticleTitleThe appearance on MRI of vertebrae in acute compression of the spinal cord due to metastases J. Bone Joint Surg.–Brit Vol 81 830–834 Occurrence Handle10.1302/0301-620X.81B5.9600

    Article  Google Scholar 

  20. F Arguello RB Baggs RE Duerst L Johnstone K McQueen CN Frantz (1990) ArticleTitlePathogenesis of vertebral metastasis and epidural spinal cord compression Cancer 65 98–106 Occurrence Handle2293874

    PubMed  Google Scholar 

  21. RA Henson H Urich (1982) Cancer and the Nervous System Blackwell Scientific Publications Oxford; Boston, Mo

    Google Scholar 

  22. Schiff D, Shaffrey ME: Spinal epidural metastases. In: Rabinstein AA, Wijdicks E (eds) Tough Calls in Neurology (in press).

  23. Y Ushio R Posner JB Posner WR Shapiro (1977) ArticleTitleExperimental spinal cord compression by epidural neoplasm Neurology 27 422–429 Occurrence Handle558545

    PubMed  Google Scholar 

  24. S Helweg-Larsen PS Sorensen (1994) ArticleTitleSymptoms and signs in metastatic spinal cord compression: a study of progression from first symptom until diagnosis in 153 patients Eur J Cancer 30A 396–398 Occurrence Handle10.1016/0959-8049(94)90263-1 Occurrence Handle8204366

    Article  PubMed  Google Scholar 

  25. JB Posner (1995) Neurologic complications of cancer F.A. Davis Company Philadelphia

    Google Scholar 

  26. J Hardy JR Cowap R A'Hern (2000) ArticleTitleOutcome of malignant spinal cord compression at a cancer center: implications for palliative care services J Pain Symptom Manage 19 257–264 Occurrence Handle10.1016/S0885-3924(00)00110-X Occurrence Handle10799792

    Article  PubMed  Google Scholar 

  27. M Onimus P Papin S Gangloff (1996) ArticleTitleResults of surgical treatment of spinal thoracic and lumbar metastases Eur Spine J 5 407–411 Occurrence Handle10.1007/BF00301969 Occurrence Handle8988384

    Article  PubMed  Google Scholar 

  28. HS Greenberg JH Kim JB Posner (1980) ArticleTitleEpidural spinal cord compression from metastatic tumor: results with a new treatment protocol Ann Neurol 8 361–366 Occurrence Handle10.1002/ana.410080404 Occurrence Handle7436380

    Article  PubMed  Google Scholar 

  29. GF Findlay (1984) ArticleTitleAdverse effects of the management of malignant spinal cord compression J Neurol Neurosurg Psychiatry 47 761–768 Occurrence Handle6470717

    PubMed  Google Scholar 

  30. DJ Husband (1998) ArticleTitleMalignant spinal cord compression: prospective study of delays in referral and treatment BMJ 317 18–21 Occurrence Handle9651261

    PubMed  Google Scholar 

  31. RW Gilbert JH Kim JB Posner (1978) ArticleTitleEpidural spinal cord compression from metastatic tumor: diagnosis and treatment Ann Neurol 3 40–51 Occurrence Handle10.1002/ana.410030107 Occurrence Handle655653

    Article  PubMed  Google Scholar 

  32. B Hainline MH Tuszynski JB Posner (1992) ArticleTitleAtaxia in epidural spinal cord compression Neurology 42 2193–2195 Occurrence Handle1436534

    PubMed  Google Scholar 

  33. GE Kienstra CB Terwee FW Dekker LR Canta AC Borstlap CC Tijssen DA Bosch JG Tijssen (2000) ArticleTitlePrediction of spinal epidural metastases Arch Neurol 57 690–695 Occurrence Handle10.1001/archneur.57.5.690 Occurrence Handle10815135

    Article  PubMed  Google Scholar 

  34. AG Osborn (1994) Diagnostic Neuroradiology Mosby-Year Book, Inc. St. Louis, Mo 893–895

    Google Scholar 

  35. EW Olcott WP Dillon (1993) ArticleTitlePlain film clues to the diagnosis of spinal epidural neoplasm and infection Neuroradiology 35 288–292 Occurrence Handle10.1007/BF00602618 Occurrence Handle8492898

    Article  PubMed  Google Scholar 

  36. F Graus G Krol KM Foley (1985) ArticleTitleEarly diagnosis of spinal epidural metastases (SEM): correlation with clinical and radiological findings Proc Am Soc Clin Oncol 4 269

    Google Scholar 

  37. RK Portenoy BS Galer O Salamon M Freilich JE Finkel D Milstein HT Thaler M Berger RB Lipton (1989) ArticleTitleIdentification of epidural neoplasm: radiography and bone scintigraphy in the symptomatic and asymptomatic spine Cancer 64 2207–2213 Occurrence Handle2804911

    PubMed  Google Scholar 

  38. HH Bather CM Loftus (2003) Textbook of Neurological Surgery Lippincott Williams and Wilkins Philadelphia 1811–1820

    Google Scholar 

  39. PR Algra JL Bloem H Tissing TH Falke JW Arndt LJ Verboom (1991) ArticleTitleDetection of vertebral metastases: comparison between MR imaging and bone scintigraphy Radiographics 11 219–232 Occurrence Handle2028061

    PubMed  Google Scholar 

  40. JJ Kransdorf MJ Peterson MI O'Connor (2003) ArticleTitleDiagnosis of occult bone metastases: positron emission tomography Clin Orthop 415 Suppl S120–S128 Occurrence Handle14600601

    PubMed  Google Scholar 

  41. DI Rosenthal (1997) ArticleTitleRadiologic diagnosis of bone metastases Cancer 80 IssueID8 Suppl 1595–607 Occurrence Handle10.1002/(SICI)1097-0142(19971015)80:8+<1595::AID-CNCR10>3.0.CO;2-V Occurrence Handle9362427

    Article  PubMed  Google Scholar 

  42. TN Byrne (1992) ArticleTitleSpinal cord compression from epidural metastases N Eng J Med 327 614–619

    Google Scholar 

  43. HH Lien V Blomlie K Heimdal (1990) ArticleTitleMagnetic resonance imaging of malignant extradural tumors with acute spinal cord compression Acta Radiol 31 187–190 Occurrence Handle2372462

    PubMed  Google Scholar 

  44. MC Chamberlain PA Kormanik (1999) ArticleTitleEpidural spinal cord compression: a single institution's retrospective experience Neuro-oncology 1 120–123 Occurrence Handle10.1215/S1522851798000027 Occurrence Handle11550307

    Article  PubMed  Google Scholar 

  45. D O'Neill BP Schiff CH Wang JR O'Fallon (1998) ArticleTitleNeuroimaging and treatment implications of patients with multiple epidural spinal metastases Cancer 83 1593–1601 Occurrence Handle10.1002/(SICI)1097-0142(19981015)83:8<1593::AID-CNCR14>3.0.CO;2-H Occurrence Handle9781953

    Article  PubMed  Google Scholar 

  46. PM Colletti HJ Siegel MY Woo HY Young MR Terk (1996) ArticleTitleThe impact on treatment planning of MRI of the spine in patients suspected of vertebral metastasis: an efficacy study Comput Med Imaging Graph 20 159–162 Occurrence Handle10.1016/0895-6111(96)00009-2 Occurrence Handle8930468

    Article  PubMed  Google Scholar 

  47. DJ Husband KA Grant CS Romaniuk (2001) ArticleTitleMRI in the diagnosis and treatment of suspected malignant spinal cord compression Br J Radiol 74 15–23 Occurrence Handle11227772

    PubMed  Google Scholar 

  48. RK Portenoy RB Lipton KM Foley (1987) ArticleTitleBack pain in the cancer patient: an algorithm for evaluation and management Neurology 37 134–138 Occurrence Handle2948135

    PubMed  Google Scholar 

  49. RL Ruff DJ Lanska (1989) ArticleTitleEpidural metastases in prospectively evaluated veterans with cancer and back pain Cancer 63 2234–2241 Occurrence Handle2524249

    PubMed  Google Scholar 

  50. JJ Sande Particlevan der R Kroger W Boogerd (1990) ArticleTitleMultiple spinal epidural metastases; an unexpectedly frequent finding J Neurol Neurosurg Psychiatry 53 1001–1003 Occurrence Handle2283511

    PubMed  Google Scholar 

  51. D Vanel J Bittoun A Tardivon (1998) ArticleTitleMRI of bone metastases Eur Radiol. 8 1345–1351 Occurrence Handle10.1007/s003300050549 Occurrence Handle9853211

    Article  PubMed  Google Scholar 

  52. WC Broaddus MS Grady JB Delashaw SuffixJr RD Ferguson JA Jane (1990) ArticleTitlePreoperative superselective arteriolar embolization: a new approach to enhance resectability of spinal tumors Neurosurgery 27 755–759 Occurrence Handle10.1097/00006123-199011000-00013 Occurrence Handle2259405

    Article  PubMed  Google Scholar 

  53. DA Loblaw NJ Laperriere (1998) ArticleTitleEmergency treatment of malignant extradural spinal cord compression: an evidence-based guideline J Clin Oncol 16 1613–1624 Occurrence Handle9552073

    PubMed  Google Scholar 

  54. KD Harrington (1988) ArticleTitleAnterior decompression and stabilization of the spine as a treatment for vertebral collapse and spinal cord compression from metastatic malignancy Clin Orthop 233 177–197 Occurrence Handle3402124

    PubMed  Google Scholar 

  55. P Kluger A Korge HP Scharf (1997) ArticleTitleStrategy for the treatment of patients with spinal neoplasms Spinal Cord 35 429–436 Occurrence Handle10.1038/sj.sc.3100413 Occurrence Handle9232747

    Article  PubMed  Google Scholar 

  56. JD Rompe P Eysel C Hopf J Heine (1993) ArticleTitleDecompression/stabilization of the metastatic spine Cotrel-Dubousset-Instrumentation in 50 patients. Acta Orthop Scand 64 3–8

    Google Scholar 

  57. N Sundaresan AA Steinberger F Moore VP Sachdev G Krol L Hough K Kelliher (1996) ArticleTitleIndications and results of combined anterior–posterior approaches for spine tumor surgery Neurosurgery 85 438–446

    Google Scholar 

  58. K Tomita N Kawahara T Kobayashi A Yoshida H Murakami T Akamaru (2001) ArticleTitleSurgical strategy for spinal metastases Spine 26 298–306 Occurrence Handle10.1097/00007632-200102010-00016 Occurrence Handle11224867

    Article  PubMed  Google Scholar 

  59. S Helweg-Larsen A Johnsen J Boesen PS Sorensen (1997) ArticleTitleRadiologic features compared to clinical findings in a prospective study of 153 patients with metastatic spinal cord compression treated by radiotherapy Acta Neurochir (Wien) 139 105–111

    Google Scholar 

  60. S Helweg-Larsen (1996) ArticleTitleClinical outcome in metastatic spinal cord compression A prospective study of 153 patients. Acta Neurol Scand 94 269–275

    Google Scholar 

  61. RC Cantu (1968) ArticleTitleCorticosteroids for spinal metastases Lancet 2 912 Occurrence Handle10.1016/S0140-6736(68)91076-3

    Article  Google Scholar 

  62. JY Delattre E Arbit MK Rosenblum HT Thaler N Lau JH Galicich JB Posner (1988) ArticleTitleHigh dose versus low dose dexamethasone in experimental epidural spinal cord compression Neurosurgery 22 1005–1007 Occurrence Handle3419560

    PubMed  Google Scholar 

  63. JY Delattre E Arbit HT Thaler MK Rosenblum JB Posner (1989) ArticleTitleA dose–response study of dexamethasone in a model of spinal cord compression caused by epidural tumor J Neurosurg 70 920–925 Occurrence Handle2715820

    PubMed  Google Scholar 

  64. Y Ushio R Posner JH Kim WR Shapiro JB Posner (1977) ArticleTitleTreatment of experimental spinal cord compression caused by extradural neoplasms J Neurosurg 47 380–390 Occurrence Handle894341

    PubMed  Google Scholar 

  65. S Sorensen S Helweg-Larsen H Mouridsen HH Hansen (1994) ArticleTitleEffect of high-dose dexamethasone in carcinomatous metastatic spinal cord compression treated with radiotherapy: a randomised trial Eur J Cancer 30A 22–27 Occurrence Handle8142159

    PubMed  Google Scholar 

  66. CJ Vecht H Haaxma-Reiche WL Putten Particlevan M de Visser Particlede EP Vries A Twijnstra (1989) ArticleTitleInitial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression Neurology 39 1255–1257 Occurrence Handle2771077

    PubMed  Google Scholar 

  67. CJ Vecht H Haaxma-Reiche WL Putten Particlevan M Visser Particlede EP Vries A Twijnstra (1992) ArticleTitleHigh incidence of serious side effects of high-dose dexamethasone treatment in patients with epidural spinal cord compression J Neurooncol 12 141–144 Occurrence Handle1560260

    PubMed  Google Scholar 

  68. E Maranzano P Latini S Beneventi E Perruci BM Panizza C Aristei M Lupattelli M Tonato (1996) ArticleTitleRadiotherapy without steroids in selected metastatic spinal cord compression patients A phase II trial. Am J Clin Oncol 19 179–183

    Google Scholar 

  69. Y Guo B Young JL Palmer Y Mun E Bruera (2003) ArticleTitlePrognostic factors for survival in metastatic spinal cord compression: a retrospective study in a rehabilitation setting Am J Phys Med Rehabil 82 665–682 Occurrence Handle10.1097/01.PHM.0000083662.85497.1F Occurrence Handle12960907

    Article  PubMed  Google Scholar 

  70. S Helweg-Larsen PS Sorensen S Kreiner (2000) ArticleTitlePrognostic factors in metastatic spinal cord compression: a prospective study using multivariate analysis of variables influencing survival and gait function in 153 patients Int J Radiat Oncol Biol Phys 46 1163–1169 Occurrence Handle10.1016/S0360-3016(99)00333-8 Occurrence Handle10725627

    Article  PubMed  Google Scholar 

  71. OO Zaidat RL Ruff (2002) ArticleTitleTreatment of spinal epidural metastasis improves patient survival and functional state Neurology 58 1360–1366 Occurrence Handle12011281

    PubMed  Google Scholar 

  72. WO McKinley AR Conti-Wyneken CW Vokac DX Cifu (1996) ArticleTitleRehabilitative functional outcome of patients with neoplastic spinal cord compressions Arch Phys Med Rehabil. 77 892–895 Occurrence Handle10.1016/S0003-9993(96)90276-2 Occurrence Handle8822680

    Article  PubMed  Google Scholar 

  73. D Tong L Gillick FR Hendrickson (1982) ArticleTitleThe palliation of symptomatic osseous metastases: final results of the Study by the Radiation Therapy Oncology Group Cancer 50 893–899 Occurrence Handle6178497

    PubMed  Google Scholar 

  74. D Rades JH Karstens W Alberti (2002) ArticleTitleRole of radiotherapy in the treatment of motor dysfunction due to metastatic spinal cord compression: comparison of three different fractionation schedules Int J Radiat Oncol Biol Phys 54 1160–1164 Occurrence Handle10.1016/S0360-3016(02)02979-6 Occurrence Handle12419444

    Article  PubMed  Google Scholar 

  75. M Lupattelli E Maranzano R Bellavita F Chionne S Darwish F Piro P Latini (2000) ArticleTitleShort-course palliative radiotherapy in non-small-cell lung cancer: results of a prospective study Am J Clin Oncol 23 89–93 Occurrence Handle10.1097/00000421-200002000-00024 Occurrence Handle10683087

    Article  PubMed  Google Scholar 

  76. E Maranzano R Bellavita P Floridi G Celani E Righetti M Lupattelli BM Panizza A Frattegiani GP Pelliccioli P Latini (2001) ArticleTitleRadiation-induced myelopathy in long-term surviving metastatic spinal cord compression patients after hypofractionated radiotherapy: a clinical and magnetic resonance imaging analysis Radiother Oncol 60 281–288 Occurrence Handle10.1016/S0167-8140(01)00356-5 Occurrence Handle11514008

    Article  PubMed  Google Scholar 

  77. JA Martenson SuffixJr RG Evans MR Lie DM Ilstrup RP Dinapoli MJ Ebersold JD Earle (1985) ArticleTitleTreatment outcome and complications in patients treated for malignant epidural spinal cord compression (SCC) J Neurooncol 3 77–84 Occurrence Handle10.1007/BF00165175 Occurrence Handle3998791

    Article  PubMed  Google Scholar 

  78. HC Bauer R Wedin (1995) ArticleTitleSurvival after surgery for spinal and extremity metastases Prognostication in 241 patients. Acta Orthop Scand 66 143–146

    Google Scholar 

  79. PJ Sioutos E Arbit CF Meshulam JH Galicich (1995) ArticleTitleSpinal metastases from solid tumors Analysis of factors affecting survival. Cancer 76 1453–1459

    Google Scholar 

  80. H Tatsui T Onomura S Morishita M Oketa T Inoue (1996) ArticleTitleSurvival rates of patients with metastatic spinal cancer after scintigraphic detection of abnormal radioactive accumulation Spine 21 2143–2148 Occurrence Handle10.1097/00007632-199609150-00017 Occurrence Handle8893440

    Article  PubMed  Google Scholar 

  81. S Helweg-Larsen B Rasmusson PS Sorensen (1990) ArticleTitleRecovery of gait after radiotherapy in paralytic patients with metastatic epidural spinal cord compression Neurology 40 1234–1236 Occurrence Handle2381531

    PubMed  Google Scholar 

  82. T Tomita JH Galicich N Sundaresan (1983) ArticleTitleRadiation therapy for spinal epidural metastases with complete block Acta Radiol Oncol 22 135–143 Occurrence Handle6310968

    PubMed  Google Scholar 

  83. JS Loeffler AS Glicksman M Tefft M Gelch (1983) ArticleTitleTreatment of spinal cord compression: a retrospective analysis Med Pediatr Oncol 11 347–351 Occurrence Handle6633426

    PubMed  Google Scholar 

  84. CL Rogers N Theodore CA Dickman VK Sonntag T Thomas S Lam BL Speiser (2002) ArticleTitleSurgery and permanent 125I seed paraspinal brachytherapy for malignant tumors with spinal cord compression Int J Radiat Oncol Biol Phys. 54 505–513 Occurrence Handle10.1016/S0360-3016(02)02961-9 Occurrence Handle12243829

    Article  PubMed  Google Scholar 

  85. H Hirabayashi S Ebara T Kinoshita Y Yuzawa I Nakamura J Takahashi M Kamimura K Ohtsuka K Takaoka (2002) ArticleTitleClinical outcome and survival after palliative surgery for spinal metastases: palliative surgery in spinal metastases Cancer 97 479–484

    Google Scholar 

  86. A Garcia-Picazo P Capilla Ramirez P Pulido Rivas R Garcia Sola Particlede (1990) ArticleTitleUtility of surgery in the treatment of epidural vertebral metastases Acta Neurochir (Wien) 103 131–138 Occurrence Handle10.1007/BF01407520

    Article  Google Scholar 

  87. DR Fourney D Abi-Said FF Lang IE McCutcheon ZL Gokaslan (2001) ArticleTitleUse of pedicle screw fixation in the management of malignant spinal disease: Experience in 100 consecutive procedures J Neurosurg 94 25–37 Occurrence Handle11147865

    PubMed  Google Scholar 

  88. H Pascal-Moussellard G Broc V Pointillart F Simeon JM Vital J Senegas (1998) ArticleTitleComplications of vertebral metastasis surgery Eur Spine J 7 438–444 Occurrence Handle10.1007/s005860050105 Occurrence Handle9883951

    Article  PubMed  Google Scholar 

  89. JJ Wise JS Fischgrund HN Herkowitz D Montgomery LT Kurz (1999) ArticleTitleComplications, survival rates, and risk factors of surgery for metastatic disease of the spine Spine 24 1943–1951 Occurrence Handle10.1097/00007632-199909150-00014 Occurrence Handle10515021

    Article  PubMed  Google Scholar 

  90. Y Tokuhashi H Matsuzaki S Toriyama H Kawano S Ohsaka (1990) ArticleTitleScoring system for the preoperative evaluation of metastatic spine tumor prognosis Spine 15 1110–1113 Occurrence Handle1702559

    PubMed  Google Scholar 

  91. EA Enkaoua L Doursounian G Chatellier F Mabesoone T Aimard G Saillant (1997) ArticleTitleVerebral metastases A critical application of the preoperative prognostic Tokuhashi score in a series of 71 cases. Spine 22 2293–2298

    Google Scholar 

  92. A Schoeggl M Reddy C Matula (2002) ArticleTitleNeurological outcome following laminectomy in spinal metastases Spinal Cord 40 363–366 Occurrence Handle10.1038/sj.sc.3101324 Occurrence Handle12080464

    Article  PubMed  Google Scholar 

  93. MH Bilsky P Boland E Lis JJ Raizer JH Healey (2000) ArticleTitleSingle-stage posterolateral transpedicle approach for spondylectomy, epidural decompression, and circumferential fusion of spinal metastases Spine 25 2240–2250 Occurrence Handle10.1097/00007632-200009010-00016 Occurrence Handle10973409

    Article  PubMed  Google Scholar 

  94. T Siegal T Siegal G Robin I Lubetzki-Korn Z Fuks (1982) ArticleTitleAnterior decompression of the spine for metastatic epidural cord compression: a promising avenue of therapy Ann Neurol 11 28–34 Occurrence Handle10.1002/ana.410110106 Occurrence Handle6174073

    Article  PubMed  Google Scholar 

  95. N Sundaresan VP Sachdev JF Holland F Moore M Sung PA Paciucci LT Wu K Kelligher L Hough (1995) ArticleTitleSurgical treatment of spinal cord compression from epidural metastasis J Clin Oncol 13 2330–2335 Occurrence Handle7666091

    PubMed  Google Scholar 

  96. N Sundaresan GV Digiacinto JE Hughes M Cafferty A Vallejo (1991) ArticleTitleTreatment of neoplastic spinal cord compression: results of a prospective study Neurosurgery 29 645–650 Occurrence Handle10.1097/00006123-199111000-00001 Occurrence Handle1961391

    Article  PubMed  Google Scholar 

  97. JK Harris JC Sutcliffe NE Robinson (1996) ArticleTitleThe role of emergency surgery in malignant spinal extradural compression: assessment of functional outcome Br J Neurosurg 10 27–33 Occurrence Handle10.1080/02688699650040494 Occurrence Handle8672255

    Article  PubMed  Google Scholar 

  98. ASIA/IMSOP. International Standards for Neurological and Functional Classification of Spinal Cord Injury–revised 1996 Chicago, IL: ASIA, 1996.

  99. HDH Frankel DO Hancock G Hyslop J Melzak LS Michaelis GH Ungar JDS Vernon JJ Walsh (1969) ArticleTitleThe value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia Paraplegia 7 179–192 Occurrence Handle5360915

    PubMed  Google Scholar 

  100. Regine W, Tibbs P, Young A, et al. Metastatic spinal cord compression: a randomized trial of direct decompressive surgical resection plus radiotherapy vs. radiotherapy alone [Abstract 3]. In: Proceedings of the 45th Annual ASTRO Meeting (Salt Lake City), 2003: S125.

  101. PA Burch SA Grossman (1988) ArticleTitleTreatment of epidural cord compressions from Hodgkin's disease with chemotherapy. A report of two cases and a review of the literature Am J Med 84 555–558 Occurrence Handle10.1016/0002-9343(88)90284-7 Occurrence Handle3279772

    Article  PubMed  Google Scholar 

  102. ET Wong CS Portlock JP O'Brien LM Angelis ParticleDe (1996) ArticleTitleChemosensitive epidural spinal cord disease in non-Hodgkins lymphoma Neurology 46 1543–1547 Occurrence Handle8649545

    PubMed  Google Scholar 

  103. W Boogerd JJ Sande Particlevan der R Kroger PF Bruning R Somers (1989) ArticleTitleEffective systemic therapy for spinal epidural metastases from breast carcinoma Eur J Cancer Clin Oncol 25 149–153 Occurrence Handle10.1016/0277-5379(89)90066-7 Occurrence Handle2920764

    Article  PubMed  Google Scholar 

  104. K Cooper D Bajorin W Shapiro G Krol G Sze GJ Bosl (1990) ArticleTitleDecompression of epidural metastases from germ cell tumors with chemotherapy J Neurooncol 8 275–280 Occurrence Handle10.1007/BF00177361 Occurrence Handle2162918

    Article  PubMed  Google Scholar 

  105. FA Hayes EI Thompson E Hvizdala D O'Connor AA Green (1984) ArticleTitleChemotherapy as an alternative to laminectomy and radiation in the management of epidural tumor J Pediatr 104 221–224 Occurrence Handle6694014

    PubMed  Google Scholar 

  106. W Boogerd JJ Sande Particlevan der R Kroger (1992) ArticleTitleEarly diagnosis and treatment of spinal epidural metastasis in breast cancer: a prospective study J Neurol Neurosurg Psychiatry 55 1188–1193 Occurrence Handle1479399

    PubMed  Google Scholar 

  107. I Sasagawa H Gotoh H Miyabayashi O Yamaguchi Y Shiraiwa (1991) ArticleTitleHormonal treatment of symptomatic spinal cord compression in advanced prostatic cancer Int Urol Nephrol 23 351–356 Occurrence Handle1938231

    PubMed  Google Scholar 

  108. AJ Hamilton BA Lulu H Fosmire L Gossett (1996) ArticleTitleLINAC-based spinal stereotactic radiosurgery Stereotact Funct Neurosurg 66 1–9

    Google Scholar 

  109. SD Chang W Main DP Martin IC Gibbs MP Heilbrun (2003) ArticleTitleAn analysis of the accuracy of the CyberKnife: a robotic frameless stereotactic radiosurgical system Neurosurgery 52 140–147 Occurrence Handle10.1097/00006123-200301000-00018 Occurrence Handle12493111

    Article  PubMed  Google Scholar 

  110. KM Yenice DM Lovelock MA Hunt WR Lutz N Fournier-Bidoz CH Hua J Yamada M Bilsky H Lee K Pfaff SV Spirou HI Amols (2003) ArticleTitleCT image-guided intensity-modulated therapy for paraspinal tumors using stereotactic immobilization Int J Radiat Oncol Biol Phys 55 583–593 Occurrence Handle10.1016/S0360-3016(02)03942-1 Occurrence Handle12573745

    Article  PubMed  Google Scholar 

  111. AS Shiu EL Chang JS Ye M Lii LD Rhines E Mendel J Weinberg S Singh MH Maor R Mohan JD Cox (2003) ArticleTitleNear simultaneous computed tomography image-guided stereotactic spinal radiotherapy: an emerging paradigm for achieving true stereotaxy Int J Radiat Oncol Biol Phys 57 605–613 Occurrence Handle10.1016/S0360-3016(03)00792-2 Occurrence Handle14529763

    Article  PubMed  Google Scholar 

  112. S Ryu F Fang Yin J Rock J Zhu A Chu E Kagan L Rogers M Ajlouni M Rosenblum JH Kim (2003) ArticleTitleImage-guided and intensity-modulated radiosurgery for patients with spinal metastasis Cancer 97 2013–2018 Occurrence Handle10.1002/cncr.11296 Occurrence Handle12673732

    Article  PubMed  Google Scholar 

  113. JJ Sande Particlevan der W Boogerd R Kroger AV Kappelle (1999) ArticleTitleRecurrent spinal epidural metastases: a prospective study with a complete follow up J Neurol Neurosurg Psychiatry 66 623–627 Occurrence Handle10209174

    PubMed  Google Scholar 

  114. D Schiff EG Shaw TL Cascino (1995) ArticleTitleOutcome after spinal reirradiation for malignant epidural spinal cord compression Ann Neurol 37 583–589 Occurrence Handle10.1002/ana.410370507 Occurrence Handle7755352

    Article  PubMed  Google Scholar 

  115. V Heidecke NG Rainov W Burkert (2003) ArticleTitleResults and outcome of neurosurgical treatment for extradural metastases in the cervical spine Acta Neurochir (Wien) 145 873–881 Occurrence Handle10.1007/s00701-003-0107-1

    Article  Google Scholar 

  116. D Schiff BP O'Neill (1996) ArticleTitleIntramedullary spinal cord metastases: clinical features and treatment outcome Neurology 47 906–912 Occurrence Handle8857717

    PubMed  Google Scholar 

  117. DA Costigan MD Winkelman (1985) ArticleTitleIntramedullary spinal cord metastasis, a clinicopathological study of 13 cases J Neurosurg 62 227–233 Occurrence Handle3968561

    PubMed  Google Scholar 

  118. H Okamoto T Shinkai Y Matsuno N Saijo (1993) ArticleTitleIntradural parenchymal involvement in the spinal subarachnoid space associated with primary lung cancer Cancer 72 2583–2588 Occurrence Handle8402479

    PubMed  Google Scholar 

  119. ES Connolly SuffixJr CJ Winfree PC McCormick M Cruz BM Stein (1996) ArticleTitleIntramedullary spinal cord metastasis: report of three cases and review of the literature Surg Neurol. 46 329–337 Occurrence Handle10.1016/S0090-3019(96)00162-0 Occurrence Handle8876713

    Article  PubMed  Google Scholar 

  120. JL Grem J Burgess DL Trump (1985) ArticleTitleClinical features and natural history of intramedullary spinal cord metastasis Cancer 56 2305–2314 Occurrence Handle4052974

    PubMed  Google Scholar 

  121. K Jellinger P Kothbauer E Sunder-Plassmann R Weiss (1979) ArticleTitleIntramedullary spinal cord metastases J Neurol 220 31–41 Occurrence Handle10.1007/BF00313146 Occurrence Handle84065

    Article  PubMed  Google Scholar 

  122. JW Dunne CG Harper R Pamphlett (1986) ArticleTitleIntramedullary spinal cord metastases: a clinical and pathological study of nine cases Q J Med 61 1003–1020 Occurrence Handle3659245

    PubMed  Google Scholar 

  123. M Fakih D Schiff R Erlich TF Logan (2001) ArticleTitleIntramedullary spinal cord metastasis (ISCM) in renal cell carcinoma: a series of six cases Ann Oncol 12 1113–1117 Occurrence Handle10.1023/A:1011693212682

    Article  Google Scholar 

  124. M Ogino R Ueda M Nakatsukasa I Murase (2002) ArticleTitleSuccessful removal of solitary intramedullary spinal cord metastasis from colon cancer Clin Neurol Neurosurg 104 152–156 Occurrence Handle10.1016/S0303-8467(02)00004-5 Occurrence Handle11932047

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Virginia, USA

    Melike Mut, David Schiff & Mark E. Shaffrey

  2. Division of Neuro-Oncology, University of Virginia, P.O. Box 800432, Charlottesville, VA, 22908-0432

    David Schiff

Authors
  1. Melike Mut
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Schiff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark E. Shaffrey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Schiff.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mut, M., Schiff, D. & Shaffrey, M.E. Metastasis to nervous system: spinal epidural and intramedullary metastases. J Neurooncol 75, 43–56 (2005). https://doi.org/10.1007/s11060-004-8097-2

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-004-8097-2

Keywords

Search

Navigation