Henry Ford Hospital Medical Journal


In a series of 60 patients undergoing decompression laminectomy for metastatic malignancy, the median survival was 3.3 months with 11 patients (18%) living for at least one year and ambulating during part of this survival period. Forty-three per cent of the group were able to ambulate for at least some period postoperatively. If a patient could ambulate preoperatively he had a two-thirds chance of ambulating afterwards; conversely, if he could not ambulate preoperatively. he had a two-thirds chance of not ambulating postoperatively. The lymphoma group had the best prognosis. Long lesions and highly vascular tumors fared poorly. Paralysis (as defined by inability to ambulate) had developed with great rapidity in half of the patients unable to walk prior to operation. We postulate that this was caused by infarction of the spinal cord. A plea is made for early diagnosis and effective removal of these lesions before signs of cord compression are evident, and especially before the patient loses his ability to walk.