[Role and technical aspects of surgery for spinal metastases from urological malignancies]

The improved survival rate in urologic carcinoma notably due to anti-angiogenic drugs is directly associated with increased incidence of spinal metastases. During spinal metastasis cord compression it has been proved that surgery associated with radiotherapy gives better results that radiotherapy alone. The neurotoxic risk of the spine metastasis must be evaluated before neurological signs appear in order to propose, if necessary decompressive surgery with stabilisation of the lesion. The choices of therapeutic approach are quite large ranging from percutaneous cimentoplasty to vertebral replacement. It is essential that the initial treatment of metastasis be discussed before neurologic signs appear.