This 2008 narrative review from MD Anderson traces the evolution of surgery for metastatic spinal tumors causing epidural compression — from discredited posterior laminectomy to modern circumferential resection with reconstruction — and uses an institutional series of 5,504 patients to examine which tumors get operated on and why.
When you encounter a patient with metastatic spinal cord compression, the first question is tumor histology: radiosensitive tumors (lymphoma, myeloma) go to radiation first, while radio-resistant primaries (renal cell, melanoma, non-small cell lung) typically need upfront surgery followed by radiation 2–4 weeks later.
Critically, plan surgery before radiotherapy — operating through an irradiated field significantly increases wound complications.
This 2008 narrative review from MD Anderson traces the evolution of surgery for metastatic spinal tumors causing epidural compression — from discredited posterior laminectomy to modern circumferential resection with reconstruction — and uses an institutional series of 5,504 patients to examine which tumors get operated on and why.
When you encounter a patient with metastatic spinal cord compression, the first question is tumor histology: radiosensitive tumors (lymphoma, myeloma) go to radiation first, while radio-resistant primaries (renal cell, melanoma, non-small cell lung) typically need upfront surgery followed by radiation 2–4 weeks later.
Critically, plan surgery before radiotherapy — operating through an irradiated field significantly increases wound complications.