Objective: We present our recent experience in the management of tumours of the cervical spine and in particular comparing patterns of presentation of benign and malignant tumours and highlighting any delays of treatment.

Design: A retrospective study of 40 patients treated operatively at a regional spinal centre between 1995 and 2001.

Results: Twenty-five patients had metastastic disease and fifteen had primary tumours, five of which were malignant. Patients with malignant disease were older at diagnosis (55 vs 40) and had a shorter duration of symptoms (3m vs 19m). All patients with metastases reported good pain relief and improvement in neurological function where myelopathy or radiculopathy was present. Eight of these twenty-five patients have died at a mean of eleven months postoperatively. The longest survivor is now 31 months surgery. There were some excessive delays in treatment in benign and malignant cases. There were five cases of missed or wrong diagnosis and three patients waited more than six months for investigations.

Conclusions: Surgery for metastatic disease in the cervical spine has been successful in improving the quality of life in all of the patients although it should be stressed that each case must be dealt with on an individual basis with a multidisciplinary approach. It was noteworthy that some patients were subjected to extraordinary delays in diagnosis.