Neoplastic Spinal Cord Compression

Question 1

Which cancers are most associated with Neoplastic spinal cord compression?

Answer 1

Lung, breast and prostate cancer

Question 2

What accounts for most of the cases of neoplastic spinal cord compression?

Answer 2

Extradural compression

Question 3

What is neoplastic spinal cord compression usually due to?

Answer 3

Vertebral body metastases

Question 4

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

Answer 4

Back pain

Question 5

When does the back pain tend to be worse with neoplastic spinal cord compression?

Answer 5

When lying down
Coughing

Question 6

What are the other features of neoplastic spinal cord compression?

Answer 6

Lower limb weakness
Sensory changes: sensory loss and numbness
Neurological signs depend on the level of the lesion

Question 7

What is the main investigation for neoplastic spinal cord compression?

Answer 7

Whole MRI spine within 24 hours of presentation

Question 8

What is the medical management of Neoplastic spinal cord compression?

Answer 8

High-dose oral dexamethasone

Question 9

What is the next step in the management of neoplastic spinal cord compression?

Answer 9

Urgent oncological assessment for consideration of radiotherapy or surgery