الفهرس 
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Abstract
Spinal metastasis is common among cancer patients and it has great influence on their quality of life. It causes intractable pain, in addition to neurological deficit.
Surgery is an old widely acceptable treatment for solitary spinal metastases. It may serve as a palliative treatment as it helps to relieve pain, preserve or restore the neurological function.
The aim of this study is to evaluate the effect of different surgical modalities on the improvement of the clinical status of patients with solitary spinal metastasis.
This study included 18 patients with solitary spinal metastasis admitted to Neurosurgery Department of Al-Menoufia University in the period from January 2014 to June 2016.
Preoperatively, neurological status and pain were evaluated by the JOA scale and VAS. MRI spine with contrast was done, and cord compression was assessed by ESCC scale. All patients were evaluated by Tokuhashi scoring system.
Anterior approach was used in two patients as corpeectomy, fixation, and reconstruction were done.
Posterior approach was used in 16 patients with several surgical modalities including Posterior decompression with fixation, Posterior fixation without decompression, and Posterior fixation combined with injection of polymethylmethacrylate into the affected vertebrae.
All the patients received post-operative radiotherapy and chemotherapy. All the patients followed up for 6 months.
In this study, the pre-operative neurological condition of the patients was a strong factor influencing the post-operative improvement.