Epidural tumors and metastases

Cancer affects approximately 1.4 million Americans every year. Despite recent advancements and improvements in the care of these patents, approximately half will eventually succumb to their disease, a rate that has remained relatively unchanged over the last half century. In 2001, cancer ranked second to only heart disease in terms of mortality in the USA, accounting for approximately 23% of all deaths. The most common causes of death in oncology patients are complications related to metastasis of their primary disease [52]. The skeletal system is the third most common site for metastases, behind the lung and liver. Within the skeletal system, the spinal column is the most commonly affected site [6]. In fact, metastases are the most common type of neoplastic lesion found in the spinal column, comprising up to 90% of all spinal tumors in some series. Autopsy studies also demonstrate that upwards of 90% of cancer patients will have spinal metastatic deposits at the time of death. Of those with spinal metastases, up to 50% will require some form of treatment for their spinal metastasis and 5-10% will require surgery [3, 5, 47, 52].