Summary and Further Reading

Chapter 13 - Management of Spinal Tumours


  • Spinal oncology division compartments with 50% extradural, 40% intradural–extramedullary and 10% intramedullary manifestation
  • Spinal neuro-oncology is very similar to cranial neuro-oncology
  • Surgical management of spinal cord tumours requires a high degree of specialisation
  • Progressive neurological symptoms warrant immediate intervention to prevent progressive to irreversible deficits
  • Surgery is recommended in all symptomatic intradural-extramedullary tumours
  • Surgery of intramedullary tumours can be performed with minimal morbidity
  • Interdisciplinary decision-finding processes are recommended in primary and secondary spinal tumours
  • Indications for surgery of primary and secondary spinal tumours are isolated tumour manifestations and/or threatening paraplegia or instability
  • Surgery combined with radiotherapy is superior to radiotherapy alone
  • Spinal decompression and stabilisation is effective in reduction of pain

Further Reading

Fattal C, Fabbro M, Gelis A, Bauchet L. Metastatic paraplegia and vital prognosis: perspectives and limitations for rehabilitation care. Part 1. Arch Phys Med Rehabil 2011; 92:125–133.

Fehlings MG, Nater A, Tetreault L, et al. Survival and clinical outcomes in surgically treated patients with metastatic epidural spinal cord compression: results of the prospective multicenter AOSpine Study. J Clin Oncol 2016; 34:268–276.

Juthani RG, Bilsky MH, Vogelbaum MA. Current management and treatment modalities for intramedullary spinal cord tumors. Curr Treat Options Oncol 2015; 16:39.

Klekamp J. Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results. J Neurosurg Spine 2013; 19:12–26.

Laufer I, Rubin DG, Lis E, et al. The NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist 2013; 18:744–751.

Payer S, Mende KC, Westphal M, Eicker SO. Intramedullary spinal cord metastases: an increasingly common diagnosis. Neurosurg Focus 2015;39:E15.

Quraishi NA, Arealis G, Salem KM, et al. The surgical management of metastatic spinal tumors based on an Epidural Spinal Cord Compression (ESCC) scale. Spine J 2015, 15:1738–1743.

Raj VS, Lofton L. Rehabilitation and treatment of spinal cord tumors. J Spinal Cord Med 2013; 36:4–11.

Tokuhashu Y, Uei H, Oshima M, Ajiro Y. Scoring system for prediction of metastatic spine tumor prognosis. World J Orthop 2014; 5:262–271.

Weinstein JN, McLain RF. Primary tumors of the spine. Spine (Phila Pa 1976) 1987; 12:843–851.

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Last update: 18 September 2017