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A Role for Vertebral Biopsy in Selected Patients with Known MalignancyA Report of Three Cases
Kai-Uwe Lewandrowski, MD1; Daisuke Togawa, MD, PhD1; Thomas W. Bauer, MD, PhD1; Robert F. McLain, MD1
1 Cleveland Spine Institute (K.-U.L., D.T., T.W.B., R.F.McL.) and Orthopaedic Surgery and Anatomic Pathology (T.W.B.), The Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk A 41, Cleveland, OH 44195
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Investigation performed at The Cleveland Clinic Foundation, Cleveland, Ohio

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Jun 01;87(6):1348-1353. doi: 10.2106/JBJS.C.01664
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Skeletal metastases commonly occur in the spine1-4 and present at multiple levels in as many as 40% to 70% of patients who have disseminated malignant tumors5-7. Skeletal metastases most commonly arise from breast, lung, prostate, colorectal, and renal primary tumors as well as from lymphoreticular tumors, such as lymphoma or multiple myeloma8-12. Lesions that are metastatic to the spine represent the first manifestation of cancer in as many as 20% of symptomatic patients13,14. Overall, approximately 10% of patients with neoplastic disease are likely to have clinically important symptoms resulting from secondary lesions of the spine3,15-17.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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