Encouraging surgical results in walking patients with epidural metastases

The management of epidural metastases is in a state of controversy between combined surgical and radiation treatment and treatment by radiation alone. Review of the literature shows that one group, patients who are ambulatory before treatment, have been studied rarely. We analyzed our last 15 years of experience at the Cleveland Clinic and found 39 patients who were ambulatory preoperatively; 84% of these walked during the short term follow-up and 93% of the 1-year survivors walked. These data suggest that surgery has an important role in the management of ambulatory patients.