When the therapy of an illness falls as far short of the ultimate as does the surgical treatment of neoplastic disease, then it is necessary to reconsider frequently the principles upon which it is based and the results which it achieves. These results are twofold, curative and palliative, and, while our efforts are directed toward the former, we realize all too frequently that the best results will sometimes lie in palliation. The disappointment in accepting this lesser goal must not allow us to underestimate its importance or neglect the help that it may give.
Probably nowhere should palliation have a greater place than in malignant disease of the spinal extradural space, where a relatively simple surgical procedure might be expected to relieve pain and avert the catastrophies of paraplegia, bedsores, and incontinence. Within these limited aims the results should be good; yet this apparently is not the case. Rowbotham1
MULLAN J, EVANS JP. Neoplastic Disease of the Spinal Extradural Space: A Review of Fifty Cases. AMA Arch Surg. 1957;74(6):900–907. doi:10.1001/archsurg.1957.01280120078008
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