Treatment of Patients With Spinal Metastases From Head and Neck Neoplasms

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Abstract
EPIDURAL SPINAL cord compression from metastatic disease constitutes a major source of morbidity for cancer patients. More than one third of patients with spinal compression and neurologic symptoms will develop complete, irreversible paraplegia within 1 week if treatment is delayed.1,2 Early detection and treatment of spinal compression result in improved quality of end-stage life in patients with advanced cancer. The most important factor in determining neurologic outcome in this setting is the degree of preserved neurologic function before treatment.2-4 Overall, the incidence of spinal metastases from cancer is approximately 5%1,5; in certain malignancies, such as lung and breast carcinomas, it may be as high as 12% to 20%.6 The incidence of spinal metastases from head and neck cancer seems to be lower, with previous reports4,7 estimating it to be less than 2%. Most of the literature dealing with spinal compression in head and neck cancer is limited to case reports and small case series. Management strategies in this patient population have not been defined.