The surgical treatment of metastatic tumours of the lumbar spine.

Thirty-three patients affected by metastases in the lumbar spine were treated surgically with the objective of stabilising the affected area while at the same time alleviating involvement of the neurological structures. The surgical technique was adapted to the type and site of the lesion. The lumbar spine differs from the dorsal and cervical spine in that there are two quite different levels of neurological risk above and below L2. Above L2 it is severe, of rapid onset, and usually irreversible. Below L2 it is more easily reversible, even if surgical intervention is not carried out immediately. In cases with neurological involvement, the results were always very much better in the cases operated on early. This led us to carry out the operation prophylactically with rewarding results because none of these patients subsequently developed neurological damage.