chapter  3
13 Pages

Epidural metastasis and spinal cord compression

ByNader Pouratian, Mark E. Shaffrey, David Schiff

INTRODUCTION Metastases to the spine are second only to brain metastases in neurological complications of systemic cancer. Spinal epidural metastases (SEM) occur in 5% to 10% of all cancer patients, which translates into over 25,000 cases per year (1-3). This number is likely to increase as lifeprolonging medical and surgical therapies for systemic cancers make cancer patients more prone to systemic complications and as modern neuroimaging techniques become increasingly sensitive diagnostic tools. Although the vast majority of metastases are to the vertebral bodies and the epidural space, metastatic disease can also be identified in the leptomeninges and rarely as an intramedullary spinal cord lesion.