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Spinal Extradural Metastasis: Review of Current Treatment Options

Dr. Bartels is Staff and Associate Professor, Radboud University Nijmegen Medical Centre; and Staff, Department of Neurosurgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Dr. van der Linden is Staff Radiation Oncologist, Radiotherapeutic Institute Friesland, Leeuwarden, The Netherlands.
Dr. van der Graaf is Staff and Professor of Translational Medical Oncology, Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

    ABSTRACT

Bone metastases, especially to the spine, are frequently encountered during the course of a malignancy. Due to a worldwide increase of cancer incidence and to a longer life expectancy of patients with cancer, a rise in incidence of bone metastases is observed. A brief historical overview is the base of a review of current treatment options. Despite new developments in the surgical and radiotherapeutic fields, as well as in medical oncology, external beam radiotherapy is the cornerstone of the treatment of spinal metastases. In selected cases, surgical treatment is a proven option. Vertebroplasty or kyphoplasty can also be considered. Supportive medical care does not differ from that given for symptomatic lesions to the skeletal system elsewhere in the body. After discussing the treatment options, an algorithm is given.