Pain, weakness, or paralysis from involvement of the spinal cord and
nerve roots secondary to invasion of the vertebrae by a malignant tumor
often can be avoided or alleviated by stabilization of the spine. Twelve
patients with neoplastic infiltration of the cervical vertebrae were so
treated. The operation of wiring, augmentation bone-grafting, and
decompression of the spinal cord was successful after conservative methods
failed. Indications for operation were: (1) unremitting pain in the neck,
not relieved by bracing or radiation therapy; (2) a major degree of
vertebral destruction with loss, or impending loss, of support for the
head; (3) collapse of a vertebral body; or (4) neural deficit from local
tumor invasion. A classification of our twelve patients into three groups
helped to delineate the surgical procedure needed. The value of obtaining
spinal stability and a solid fusion above and below the tumor was evident
in eleven patients. For almost all of their survival time, they were
comfortable. Surgical treatment may not appreciably extend the lenght of a
patient's survival, but it generally improves the patient's quality of
life.