Spinal cord compression due to metastatic neoplasm

A retrospective study of 73 assessable patients with spinal cord compression due to metastatic tumor was conducted. Fifty-five patients had paraparesis and 18 were paraplegic. Treatment consisted of surgical decompression in 22 patients, radiotherapy in 31 patients, and a combination of both modalities in 20 patients. The three groups were comparable in their pretreatment characteristics. Of patients treated with surgical decompression followed by radiotherapy, 45% showed improvement in motor deficit; of patients treated with either surgery or radiotherapy, 18% (P = .06) and 16% (P = .02) showed improvement, respectively. These results were most significant in patients with paraparesis, where 47% of those who received combined therapy improved compared to 17% (P = .06) and 9% (P = .009) in the surgical and radiotherapy groups, respectively. In our series of patients with spinal cord compression due to metastatic tumor, surgical decompression followed by radiotherapy was superior to either surgical decompression or radiotherapy in improving motor deficit.