Surgery for Metastatic Spine Disease
Approximately 500,000 deaths occur per year from complications of metastatic disease. It is estimated that among living cancer patients, 10% experience symptomatic secondary metastases, with the most common sites of distant metastases being the liver, lungs, and skeleton. Within the skeleton, the spinal column has the highest incidence of metastasis, with as many as 90% of cancer patients affected on autopsy studies. The most prevalent lesions arise from breast, lung, and prostate tumors because these are the most common systemic malignancies and because they each have a marked tendency to metastasize to bone. Brihaye and colleagues reported on the origin of spinal metastasis in a large series of patients and found the breakdown of origin to be 16.5% from breast cancer, 15.6% from lung cancer, and 9.2% from prostate cancer. Surgical intervention has been estimated to occur in approximately 5% to 10% of spinal metastases; however, up to 50% of spinal metastases necessitate at least some modality of treatment. At the moment, the highest incidence of spinal metastases is found in persons 50 to 65 years of age. Women are less prone than men to develop spinal metastases, possibly due to the overall higher prevalence of systemic prostate and lung cancer when compared to breast cancer.
