Tumors cells no longer confined to an affected organ can be released through lymph and the blood stream, disseminate and form metastases. Metastases to the spine are frequent, may be painful and may occur in an isolated or multiple level manner, they may lead to structural failure of the spinal column and cause com pression of nerve structures resulting in progressive paralysis or in painful radi culopathies. The dinical evaluation as weIl as to tumor pathophysiology are weIl explai ned in...