Preoperative embolisation, transpedicular decompression and posterior stabilisation for metastatic disease of the thoracic spine causing paraplegia.

During a brief period from March 1988 to January 1990 we were faced with 13 patients with malignant vertebral neoplasms (metastasis) of the thoracic spine. Nine of these had progressive extradural spinal cord compression with motor, sensory and sphincter involvement of varying degrees and duration. After proper evaluation these 9 cases were aggressively managed by preoperative embolisation of the tumour, transpedicular decompression and a same stage posterior metallic fixation. The immediate results were encouraging, with 2 patients showing total recovery and 3 showing partial recovery. All of the 9 operated cases were pain free postoperatively and could sit up unaided and be easily transferred to the Cancer Institute for back up chemotherapy and radiotherapy. They also improved psychologically, and cooperated well in their subsequent rehabilitation programme.