Metastatic Disease

Question 1

What is metastatic disease?

Answer 1

Tumors of the spine

Question 2

What are the divisons of metastatic disease?

Answer 2

Primary
- Rare

Secondary
- Appx 50% of patients with solid tumors

Question 3

What is associated with secondary metatastic disease?

Answer 3

Breast
Lung 
Prostate
Colon
Thyroid
Kidney

Question 4

What is the presentation of metastatic disease?

Answer 4

• Incidental finding in asymptomatic patient
• Pts with primary tumor with back pain
• Neurologic finding in pts with or without primary tumor
• Back pain- primary presenting symptom

Question 5

What are the s/s of metastatic disease?

Answer 5

Pain with weight bearing activities
- Relieved by rest

Pain at night

Radiculopathy

Progression varies depending on aggressiveness of tumor

Question 6

What is observed in PE of metastatic disease?

Answer 6

Inspect for deformity

TTP
- Tumor may or may not be palpable

Neuro exam

Question 7

What imaging is used in metastatic disease?

Answer 7

AP/lat plain films

Bone scan to identify other areas of mets

Question 8

What is the treatment of metastatic disease?

Answer 8

Dependent on tumor type

Chemo, radiation, hormone therapy

Decompression and stabilization with postop radiation
- 85% improve neuro function