Complications in the management of metastatic spinal disease

Table 1 Surgical indications

Primary surgery

Radioresistant tumors (e.g., sarcoma, renal cell carcinoma)

Spinal instability

Pathologic fracture with bone in the spinal canal

Circumferential epidural tumor

Moderate to highly radio-resistant tumors (e.g., colon, lung)

Occult primary tumor

Post-treatment (radiotherapy/chemotherapy) surgery

Progressive neurologic symptoms

Progression of tumor with high grade spinal cord compression

Spinal instability

Rule out residual tumor post radiotherapy/chemotherapy