Metastatic spinal cord compression by solid tumors.

As the survival of cancer patients continues to improve, physicians in the 21st century face the challenge of early detection of metastatic spinal cord compression. Prompt diagnosis and intervention increase the likelihood of functional recovery. Because the epidural space is the most common site of spinal cord metastasis from solid tumors, this article will review the epidemiology, relevant anatomy, pathophysiology, clinical presentation, diagnostic evaluation, treatment, and prognosis for metastatic epidural spinal cord compression. Special attention will be given to the various modalities available for management of metastatic epidural spinal cord compression to maintain or restore normal spinal cord function and relieve pain. These treatment options will be considered according to patients' disease burden, life expectancy, and values. Intramedullary metastasis will be briefly discussed.