Utility of surgery in the treatment of epidural vertebral metastases.

Treatment of vertebral epidural metastases has been in the past and still remains the object of special attention in an attempt to improve the quality of life of these patients. To assess the effects of and indications for surgery, the clinical histories of 53 patients with this malignant disease who had undergone decompressive laminectomy have been reviewed retrospectively. The importance of the presence of complete or partial spinal cord compression in correlation with the presence of complete or partial myelographic block is dealt with. The results concerning pain, gait disturbances and sphincter disorders are studied with respect to the clinical and myelographic picture for the purpose of establishing the indications for decompressive laminectomy. Pain is not an indication for operative decompression, and complete paraplegia always never improves, thus being a contraindication. But in incomplete spinal cord involvement a decompression operation may be followed by an improvement of neurological deficit and quality of life.