Metastasis

The human spine is formed by individual vertebrae and connective tissue discs in between. The vertebrae form the spinal canal. There are seven cervical, twelve thoracic, and five lumbar vertebrae. The intervertebral discs are the link between the individual vertebral bodies.

The little joints that link the vertebrae together are known as facet joints. They help to stabilize the spine and, together with the intervertebral discs, allow a certain degree of mobility of the spinal cord. The spinal canal should be wide enough to allow nerve roots to float freely in cerebrospinal fluid. The front border of the spinal canal is built by the vertebral bodies and intervertebral discs, the side by the intervertebral joints (facets) and back by the ligamentum flavum (yellow band) and vertebral arches. Discs consist of an outer fibrous ring (annulus fibrosus), which surrounds an inner gel-like center (nucleus pulposus). The spinal cord and nerve roots lie within the spinal canal. The spinal cord extends downwards approx. to the 1st lumbar vertebra. Below, only nerve roots are present in the spinal canal. At the level of the intervertebral disc the nerve roots pass through the neural root foramina to exit the spinal canal. The spinal cord and nerve roots conduct electric-like signals from the skin and joints to the brain, and process of movement is initiated from the brain to the muscles.

Tumor metastasis is a tumor spread from a primary site usually via bloodstream or the lymphatic system. The most common primary tumors in women are breast or lung cancer, and prostate or lung cancer in men.

Acute compression of the spinal cord and/or nerve roots

Vertebral fracture

Severe back pain

Pain, numbness and weakness in the limbs

Unsteady gait (especially in dark rooms) Stiffness, numbness and weakness of the hands and legs Retention, or unintended urinary incontinence Numbness of the genitals and loss of sexual function

Usually treatment is surgical

Due to unfavorable courses, surgical treatment is almost always required.

Emergency operation should be performed if acute (<72 hours) paralysis, numbness in the genitals and loss of bowel/bladder control due to nerve root compression occurs. In these cases, the best results are achieved if surgery is performed within 12 hours of the onset of symptoms

Emergency operation should be performed if acute (<72 hours) paralysis due to spinal cord compression occurs. In these cases, the best results are achieved if surgery is performed within 12 hours of the onset of symptoms.

Emergency surgery should be performed if аcute (<72 hours) loss of strength in a single muscle group due to nerve root compression are present. In this case, it is advisable to perform the surgery within 72 hours of symptoms onset.

Complete tumor removal

Obtaining material for histological examination

To release the compressed nerve roots and/or spinal cord

To preserve the protective function of the spine

Posterior decompression of the spinal canal with stabilisation