Surgical Versus Nonoperative Treatment of Metastatic Epidural Spinal Cord Compression

Inclusion Criteria: * Single symptomatic metastatic epidural spinal compression at any level confirmed by MRI * Age 18 and more * Able and willing to give written informed consent to participate in the study * Able to read and write English on an elementary level Exclusion Criteria: * Multiple symptomatic spinal metastases * Radiosensitive tumors * Radioresistant tumors * Primary cancer site in CNS or spine * Poor life expectancy (\< 3 months) * Patients with a tumor that has compressed only the cauda equina or spinal roots * Has a recent history of substance abuse * Is a prisoner * Currently involved in another study * has a disease or condition that would preclude accurate evaluation