Low urgency
-Very severe
It is an increase in pressure in the bone marrow due to uncontrolled growth of malignant cells, causing an expansion effect (mass effect).
It can be caused by a primary tumour that starts in the bone marrow or by a secondary tumour that spreads from elsewhere (metastasis). The most common sites for secondary tumours are the breast, prostate and lung.
It usually causes back pain, altered sensation (loss of touch or hot/cold sensation), altered mobility and/or sphincter incontinence.
It is diagnosed by clinical and physical examination. It is confirmed by lumbar puncture and imaging studies.
Treatment aims to reduce the pressure on the spinal cord and includes corticosteroids, radiotherapy and surgery.
- David Schiff, MD. Clinical features and diagnosis of neoplastic epidural spinal cord compression, including cauda equina syndrome. UpToDate. Nov 09, 2015.
- David Schiff, MD. Paul Brown, MD. Mark Edwin Shaffrey, MD. Treatment and prognosis of neoplastic epidural spinal cord compression, including cauda equina syndrome. UpToDate. Aug 15, 2016.
- Mak KS, Lee LK, Mak RH, et al. Incidence and treatment patterns in hospitalizations for malignant spinal cord compression in the United States, 1998-2006. Int J Radiat Oncol Biol Phys 2011; 80:824.
- Cole JS, Patchell RA. Metastatic epidural spinal cord compression. Lancet Neurol 2008; 7:459.
Dr. Sara Vitoria
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