Extradural Spinal Metastases and Their Neurosurgical Treatment

W rIIILE neurosurg ica l procedures directed t oward the a l l ev ia t ion of compressive s y m p t o m s f rom metas tases to the spinal cord a n d c a u d a equ ina c o n t r i b u t e no th ing t oward cure of the unde r ly ing disease, or even t o w a r d l e n g t h e n i n g pos topera t ive su rv iva l t ime in m a n y cases, t hey can br ing a b o u t recovery f rom neurological deficit and relief f rom discomfor t . Fo l lowing is a repor t of a s t u d y of 78 cases of me ta s t a t i c naa l ignancy of the sp ine seen a t D u k e Hospi ta l f rom 1944 to 196~, wi th an appra isa l of the i r neurosurg ica l t r e a t m e n t . T h e series consisted of 34 surgical and 44 nonsurg ica l cases. All diagnoses were verified b y t issue studies, except in a few cases in which compressive s y m p t o m s of the spinal cord developed wi th a pas t h i s to ry of a ma l i gnancy , and e i ther b o n y changes compa t ib le wi th me ta s t a t i c disease occur red or a defect was seen u p o n mye logra ln . P a t i e n t s wi th general ized diseases such as l y m p h o m a , mye loma , and l eukemia were no t inc luded in this s tudy .