Neoplastic Spinal Cord Compression Flashcards

1
Q

Describe neoplastic spinal cord compression

A

Oncological emergency
Affects up to 5% of cancer patients.

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2
Q

What type of compression occurs in the majority of cases of neoplastic spinal cord compression?

A

Extradural compression, usually due to vertebral body metastases

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3
Q

Neoplastic spinal cord compression is more common in which 3 cancers?

A

Lung
Breast
Prostate

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4
Q

What is the earliest and most common symptom of neoplastic spinal cord compression?

A

Back pain
Worse on lying down + coughing

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5
Q

List 4 features of neoplastic spinal cord compression

A

Back pain
Lower limb weakness
Sensory changes: sensory loss + numbness
Neurological signs depend on level of lesion

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6
Q

What neurological changes are seen in neoplastic spinal cord compression?

A

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

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7
Q

What investigation is required for suspected neoplastic spinal cord compression?

A

Urgent whole spine MRI
(within 24h)

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8
Q

Describe management of neoplastic spinal cord compression

A

High-dose oral Dexamethasone (prior to Ix)
Urgent oncological assessment for consideration of radiotherapy or surgery

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