Spinal tumours

Spinal tumours in adults, although usually presenting with pain and neurological dysfunction, are often incidental findings. For the spinal neurosurgeon, the range of pathologies, clinical presentations, and required surgical techniques included within the management of spinal neoplasia is vast, from benign lesions unchanged over a decade of observation to malignant disease that progresses over a few hours to paraplegia, and from the finest microsurgery to instrumentation over multiple spinal segments. Surgery has a key role to play in the management of many of these, both to decompress the neurological elements of the spine and, when necessary, to reconstruct the mechanical integrity of the spine. This chapter highlights some of the challenges facing the contemporary spinal tumour surgeon.