Spinal Malignancy

‘’'Original Editor ‘’'- Jess Bell ‘’'Top Contributors’’' - Jess Bell, Lucinda hampton, Kim Jackson, Tarina van der Stockt, Admin, Tony Lowe and Vidya Acharya

Between one and five percent of all musculoskeletal presentations in primary care are due to serious pathology and these rates are expected to increase as cancer survival rates improve (REF FINUCANE ET AL 2017).

Metastatic bone disease (MBD) is the second most common serious spinal pathology - vertebral fracture is the most common (REF FINUCANE 2017). Metastases are cancers that have spread from a primary cancer to a new site in the body; bone is a common location for metastases (FINUCANE 2020).

The spine is often one of the earliest areas affected, particularly in patients who have a history of breast and prostate cancer (FINUCANE 2017). The five types of cancer that are most likely to spread to the spine are: Breast Prostate Lung Kidney Thyroid (REF FINUCANE SPINAL MALIG WEB)

It is not entirely understood how MBD spreads, but its predilection for the spine is considered to be due to hematogenous spread via the venous or arterial pathways (FINUCANE 2017).

The distribution of metastases in the spine varies. 70% occur in the thoracic spine 20% occur in the lumbar spine 10% occur in the cervical spine (REF FINUCANE 2017) NB while 70% of metastases occur in the thoracic spine, the patient may not describe thoracic pain (REF WEB).