Spinal epidural compression in head and neck cancer. Report of five cases

Patients with newly diagnosed head and neck cancer (HNC) during a 13-year period were retrospectively studied for the development of spinal epidural compression (SEC). Of the 759 patients studied, 5 developed epidural compression (1%), 4 of whom were relatively young. SEC occurred simultaneously with HNC in 2 patients and long after the diagnosis of HNC in 3 individuals. There was no observed tendency to involve a particular segment of the spine. Local control of HNC following definitive treatment along with regained ability to walk after palliative radiotherapy in a patient was associated with long-term survival. Recommendations are made for aggressive treatment of SEC to achieve a satisfactory outcome.