Neoplastic Spinal Cord Compression Flashcards
Describe neoplastic spinal cord compression
Oncological emergency
Affects up to 5% of cancer patients.
What type of compression occurs in the majority of cases of neoplastic spinal cord compression?
Extradural compression, usually due to vertebral body metastases
Neoplastic spinal cord compression is more common in which 3 cancers?
Lung
Breast
Prostate
What is the earliest and most common symptom of neoplastic spinal cord compression?
Back pain
Worse on lying down + coughing
List 4 features of neoplastic spinal cord compression
Back pain
Lower limb weakness
Sensory changes: sensory loss + numbness
Neurological signs depend on level of lesion
What neurological changes are seen in neoplastic spinal cord compression?
Lesions above L1: UMN signs in legs + a sensory level.
Lesions below L: LMN signs in legs + perianal numbness. Tendon reflexes increased below level of lesion + absent at level of lesion
What investigation is required for suspected neoplastic spinal cord compression?
Urgent whole spine MRI
(within 24h)
Describe management of neoplastic spinal cord compression
High-dose oral Dexamethasone (prior to Ix)
Urgent oncological assessment for consideration of radiotherapy or surgery