NEUROSURGERY OF SPINAL-CORD METASTASIS - ON THE WAY TO A DIFFERENTIATED OPERATION MANAGEMENT

Based on our own experience and on a thorough search of the literature, current means of treatment for spinal metastasis were critically revieved. The advantages and disadvantages of surgical treatment and radiation therapy as well as their combination with chemotherapy were compared. The main criteria for the formulation of a management concept were: the preoperative neurological status, the general condition of the patient, the speed of neurological deterioration, the site of the metastasis in the spinal canal and finally, the type of metastasis. In a typical medical history, with pain and progressive motor disturbances, early X-ray diagnosis of the spine is indicated. Myelographic examinations in connection with computer tomography and MRI of the spine are of deciding importance in formulating a plan of management of patients with spinal metastases.