What are the pathways by which metastatic disease spreads to the spine

Potential pathways for spread of metastatic disease to the spinal column include:

1. Hematogenous spread (venous or arterial route)

2. Direct tumor extension

3. Lymphatic spread

Ihe most common pathway for spread of metastatic disease is the hematogenous route. Batson's plexus, a thin-walled system of veins that extend along the entire spinal column, provides a connection with the major organ systems and is a common pathway for tumor embolization.

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