Primary, Metastatic, and Locally Aggressive Tumors of the Vertebral Column in Adults: An 11-Year Single-Center Analysis.

Introduction: Tumors of the vertebral column represent a heterogeneous group of primary and metastatic lesions requiring specialized surgical care. Epidemiological and histopathological data from Central Asia remain limited. Objective: To evaluate the demographic, histopathological, anatomical, and early neurological characteristics of adult patients surgically treated for primary and metastatic tumors of the vertebral column in Kazakhstan. Methods: A retrospective single-center observational study was conducted at the National Center for Neurosurgery, Astana, Kazakhstan. Adult patients aged ≥18 years who underwent surgery for tumors of the vertebral column between January 2015 and December 2025 were included. Demographic data, tumor origin, histopathology, anatomical localization, and early postoperative neurological outcomes were analyzed. Results: The final cohort included 148 adult patients. The mean age was 57.2 years, with a median of 59 years and a range of 22–81 years. There were 75 males (50.7%) and 73 females (49.3%). Primary tumors were identified in 51 patients (34.5%), whereas metastatic tumors were present in 97 patients (65.5%). Primary tumors were mainly represented by plasmacytoma/plasma-cell neoplasms and giant cell tumors. Among metastatic lesions, undifferentiated carcinoma was the most frequent subgroup, followed by renal cell carcinoma, breast carcinoma, and lung carcinoma. Thoracic-only involvement was the most common anatomical pattern. Pain regression was documented in 125 of 144 patients (86.8%). Among 92 patients with preoperative motor deficit, motor function improved or remained stable in 90 patients (97.8%). Conclusion: Surgically treated tumors of the vertebral column represent a relevant spinal oncology burden in Kazakhstan, with metastatic lesions predominating. These findings provide baseline surgical clinicopathological data and support the need for a national spinal oncology registry.