Symptomatic metastatic malignant melanoma to the spine

Fifteen patients with symptomatic metastatic melanoma were retrospectively reviewed. All patients had severe back pain, and seven presented with neurologic findings. The interval between spinal involvement and death was 5.9 months (range 3 weeks to 24 months). The average survival after onset of neurologic signs was 3.5 months (range 3 weeks to 7 months). In the seven patients with neurologic involvement, the average survival for the four who had surgery was 5.25 months (range 3-7 months) from the onset of symptoms and 1.2 months (range 2 weeks to 3 months) for those who did not have surgery. This dismal prognosis must be considered along with the magnitude and morbidity of any spinal procedure, the adverse impact on quality of life from neurologic compromise, and the relative failure of medical therapy for melanoma.