Therapeutical approach to unifocal lumbar vertebral metastasis of unknown origin

Low back pain often represents the first sign of a lumbar metastasis from a primary unknown tumor. In 13 cases who came to our observation, a unifocal metastasis was detected.All the patients underwent biopsy directed by computed tomography. The 8 patients who showed vertebral instability and radicular involvement underwent surgical treatment. The prognosis in cases of unifocal lumbar metastasis is related to the kind of primary tumor. Surgical treatment plays an important role in achieving pain relief and in improving life quality. Conservative care must be reserved for metastatic localizations from primary cancers that are sensitive to chemiotherapy or radiation therapy in patients without vertebral instability and neurological signs.