Spinal Metastasis: A Warning Sign You Shouldn’t Ignore
Spinal metastasis is more common than you think. Cancer that spreads to the spine is a frequently encountered and challenging condition to treat. It is found in up to 70% of cancer patients, with approximately 20% of them developing symptoms that significantly affect their quality of life, such as pain, neurological abnormalities, and disruption of daily activities.
The most common primary cancers that metastasize to the spine include:
These account for roughly two-thirds of all cases. The spine areas most often affected are:
- The thoracic region (mid-back)
- The lumbar spine
- The cervical spine (neck)
Warning Signs That Require Immediate Medical Attention
Symptoms vary depending on the location and size of the metastatic tumor. Approximately 95% of patients experience pain as the first symptom. This pain may be caused by the tumor invading the spinal bone, exerting pressure on the bone’s lining, or spinal instability due to bone destruction, fractures, or nerve compression.
Urgent symptoms that warrant immediate medical attention include:
- Severe pain that causes you to wake during the night
- Pain that worsens with movement and improves with rest
- Numbness or weakness in both arms or legs
- Difficulty walking
- Loss of bladder or bowel control
These symptoms may indicate spinal cord compression or compression of nerve bundles in the affected area, which is considered a medical emergency requiring prompt treatment.
The Importance of Timely Treatment
The success of recovery after treatment is directly related to how quickly symptoms occur and how long the spinal cord or nerves have been compressed.
If spinal cord or bilateral nerve compression is suspected, the patient should undergo MRI immediately.
Patients showing signs of spinal cord compression and muscle weakness should receive urgent treatment without delay.
Multidisciplinary Approach to Treatment
The goals of treating spinal metastasis are to:
- Relieve pain
- Restore or preserve neurological function
- Control local tumor growth
A multidisciplinary team is essential and may include:
- Medical oncologists
- Radiation oncologists
- Radiologists
- Spine surgeons
Today, minimally invasive surgical techniques and stereotactic radiation therapy (precise, targeted radiation) are utilized. These methods allow for better control of localized tumors and help patients resume treatment for their primary cancer more quickly.
Advances in systemic cancer treatment, including surgical innovations and radiation technologies, have significantly improved quality of life and survival rates for patients with spinal metastases.
Spinal metastasis and spinal cord compression have a profound impact on a patient’s quality of life and survival. Awareness of warning signs and seeking timely medical care are essential to preventing severe complications.
Modern treatments are diverse and more effective than ever. An integrated, multidisciplinary approach is crucial to achieving the best possible outcomes for patients.
By Dr. Pawin Kasempipatchai
Orthopedic and Spine Surgeon at the Bumrungrad Spine Institute
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Last modify: August 07, 2025