A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression

This report aimed to examine the natural history of metastatic spinal lesions and to identify patients at high risk of progression or spinal collapse. The use of these technologies might serve several purposes: (1) to inform the choice of potential pre-emptive intervention(s) so as to avoid or delay more radical surgical intervention; (2) to bring forward radical interventions before patients' health deteriorates to the extent that they are no longer suitable candidates for intervention; and (3) to categorise patients into those more or less suitable for earlier or later radical intervention. The first chapter examines the different types of cancer, pathological and clinical manifestation of spinal metastases, investigations, treatment, prognosis and current service cost.