The treatment of malignant tumors of the spine

Abstract

Treatment of a malignant tumor of the spine with compression of the spinal cord sufficient to give rise to a paraplegia may be a laminectomy and removal of an adequate amount of tissue to decompress the spinal cord, if the patient''s general condition is good enough to warrant such an operation. The laminectomy should be followed by radiation therapy and chemo-or hormonal therapy as indicated, depending upon the type of tumor found. If the neurological condition caused by a malignant tumor is relatively mild and if the type of tumor is known with reasonable certainty, a suitable form of nonsurgical therapy may be tried initially if the patient is kept under close observation. If the neurological symptoms advance materially or if a paraplegia develops, the patient should be operated upon without delay. Primary malignant tumors and giant-cell tumors, which are benign, offer a better prognosis than do metastatic tumors of the spine. Even though the results from the treatment of metastatic malignancy of the spine are unlikely to be permanent or very good, one can hope to make some of these patients more comfortable; enable some of them to recover control of their legs, bowel, and bladder; and eliminate some or all of their pain. With better education of the medical profession in general; with earlier operations; with improved surgical technics; and with better radiation, chemical, and hormonal therapy, it is reasonable to expect that our results will steadily improve.