Skip to main content

Neoplasic Epidural Spinal Cord Compression

  • Chapter
  • First Online:
  • 740 Accesses

Abstract

Spinal metastasis is the most common type of neoplasia, where in autopsy investigations it has been shown that up to 70% of cancer patients present it (Klimo P Jr, Schmidt MH: Oncologist 9(2):188–196, 2004; Chamberlain MC: Hematol Oncol Clin North Am 26(4):917–931, 2012). Compression of the spinal cord, an extremely devastating scenario, and mainly caused by spinal metastases with extension to the epidural space, directly affects the quality of life of cancer patients, reaching 5–10% of patients with metastatic cancer (Helweg-Larsen S, Sorensen PS, Kreiner S: Int J Radiat Oncol Biol Phys 46:1163–1169, 2000). The thoracic and lumbar spine are the most commonly affected (Klimo P Jr, Schmidt MH: Oncologist 9(2):188–196, 2004).

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Klimo P Jr, Schmidt MH (2004) Surgical management of spinal metastases. Oncologist 9(2):188–196

    Article  Google Scholar 

  2. Chamberlain MC (2012) Neoplastic meningitis and metastatic epidural spinal cord compression. Hematol Oncol Clin North Am 26(4):917–931

    Article  Google Scholar 

  3. Helweg-Larsen S, Sorensen PS, Kreiner S (2000) Prognostic factors in metastatic spinal cord compression: a prospective study using multivariate analysis of variables influencing survival and gait function in 153 patients. Int J Radiat Oncol Biol Phys 46:1163–1169

    Article  CAS  Google Scholar 

  4. Devita H (2014) Rosemberg’s cancer: principles & practice of oncology. DeVita VT Jr, Lawewnce TS, Rosemberg, SA, with 404 contributing authors. 10. Chapter 121. LWW, New York

    Google Scholar 

  5. Filis AK, Aghayev KV, Doulgeris JJ, Gonzalez-Blohm SA, Vrionis FD (2014) Spinal neoplastic instability: biomechanics and current management options. Cancer Control 21(2):144–150

    Article  Google Scholar 

  6. American Cancer Society (2005) Cancer facts and figures, 2005. American Cancer Society, Atlanta

    Google Scholar 

  7. Niederhuber JE, Armitage JO, Doroshow JH et al (2014) Abeloff’s clinical oncology, 5th edn. Elsevier, Philadelphia

    Google Scholar 

  8. MSCC Sub-group (2003) Malignan spinal cord compression. Beatson Oncology Center, Beatson

    Google Scholar 

  9. Prasad D, Schiff D (2005) Malignant spinal-cord compression. Lancet Oncol 6:15–24

    Article  Google Scholar 

  10. Helweg-Larsen S, Sorensen PS, Kreiner S (2000) Prognostic factors in metastatic spinal cord compression: a prospective study using multivariate analysis of variables influencing survival and gait function in 153 patients. Int J Radiat Oncol Biol Phys 46:1163–1169

    Article  CAS  Google Scholar 

  11. McDonald AC, Nicoll JA, Rampling RP (2000) Non-Hodgkin’s lymphoma presenting with spinal cord compression; a clinicopathological review of 25 cases. Eur J Cancer 36:207–213

    Article  CAS  Google Scholar 

  12. Bouffet E, Marec-Berard P, Thiesse P et al (1997) Spinal cord compression by secondary epi- and intradural metastases in childhood. Childs Nerv Syst 13:383–387

    Article  CAS  Google Scholar 

  13. Blair JM, Zhou H, Seibel MJ et al (2006) Mechanisms of disease: roles of OPG, RANKL, and RANK in the pathophysiology of skeletal metastasis. Nat Clin Pract Oncol 3(1):41–49

    Article  CAS  Google Scholar 

  14. Kato A, Ushio Y, Hayakawa T et al (1985) Circulatory disturbance of the spinal cord with epidural neoplasm in rats. J Neurosurg 63(2):260–265

    Article  CAS  Google Scholar 

  15. Fourney DR, Frangou EM, Ryken TC et al (2011) Spinal instability neoplastic score: an analysis of reliability and validity from the Spine Oncology Study Group. J Clin Oncol 29(22):3072–3077

    Article  Google Scholar 

  16. Chamberlain MC, Kormanik PA (1999) Epidural spinal cord compression: a single institutions retrospective experience. Neuro-Oncology 1(2):120–123

    Article  CAS  Google Scholar 

  17. Kovner F, Spigel S, Rider I et al (1999) Radiation therapy of metastatic spinal cord compression. Multidisciplinary team diagnosis and treatment. J Neuro-Oncol 42:85–92

    Article  CAS  Google Scholar 

  18. Levack P, Graham J, Collie D et al (2002) Don’t wait for a sensory level—listen to the symptoms: a prospective audit of the delays in diagnosis of malignant cord compression. Clin Oncol (R Coll Radiol) 14:472–480

    Article  CAS  Google Scholar 

  19. Posner JB (1971) Neurological complications of systemic cancer. Med Clin North Am 55:625–646

    Article  CAS  Google Scholar 

  20. Schiff D, O’Neill BP, Suman VJ (1997) Spinal epidural metastasis as the initial manifestation of malignancy. Neurology 49:452–456

    Article  CAS  Google Scholar 

  21. Rades D, Huttenlocher S, Dunst J et al (2010) Matched pair analysis compar- ing surgery followed by radiotherapy and radiotherapy alone for metastatic spinal cord compression. J Clin Oncol 28(22):3597–3604

    Article  Google Scholar 

  22. Kerr DJ, Haller DG, Van de Velde CJH, Baumann M (2016) Oxford textbook of oncology, 3rd edn. Oxford University Press, New York

    Book  Google Scholar 

  23. Brodowicz T, Hadji P, Niepel D, Diel I (2017) Early identification and intervention matters: A comprehensive review of current evidence and recommendations for the monitoring of bone health in patients with cancer. Cancer Treat Rev 61:23–34

    Article  Google Scholar 

  24. Algra PR, Bloem JL, Tissing H et al (1991) Detection of vertebral metastases: comparison between MR imaging and bone scintigraphy. Radiographics 11:219–232

    Article  CAS  Google Scholar 

  25. Schiff D, O’Neill BP, Suman VJ (1997) Spinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach. Neurology 49:452–456

    Article  CAS  Google Scholar 

  26. George R, Jeba J, Ramkumar G et al (2008) Interventions for the treatment of metastatic extradural spinal cord compression in adults. Cochrane Database Syst Rev 4:CD006716

    Google Scholar 

  27. Delattre JY, Arbit E, Rosenblum MK et al (1988) High dose versus low dose dexamethasone in experimental epidural spinal cord compression. Neurosurgery 22:1005–1007

    Article  CAS  Google Scholar 

  28. Sorensen S, Helweg-Larsen S, Mouridsen H et al (1994) Effect of high-dose dexamethasone in carcinomatous metastatic spinal cord compression treated with radiotherapy: a randomised trial. Eur J Cancer 30A:22–27

    Article  CAS  Google Scholar 

  29. Fourney DR, Frangou EM, Ryken TC et al (2011) r: an analysis of reliability and validity from the spine oncology study group. J Clin Oncol 29(22):3072–3077

    Article  Google Scholar 

  30. Kato S, Murakami H, Demura S, Yoshioka K, Kawahara N et al (2013) More than 10-year follow-up after total en bloc spondylectomy for spinal tumors. Ann Surg Oncol 21(4):1330–1336

    Article  Google Scholar 

  31. Patchell RA, Tibbs PA, Regine F et al (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by meta- static cancer: a randomised trial. Lancet 366(9486):643–648

    Article  Google Scholar 

  32. Greenberg HS, Kim JH, Posner JB (1980) Epidural spinal cord compression from metastatic tumor: results with a new treatment protocol. Ann Neurol 8:361–366

    Article  CAS  Google Scholar 

  33. Healey JH, Brown HK (2000) Complications of bone metastases: surgical management. Cancer 88:2940–2951

    Article  CAS  Google Scholar 

  34. Rosen LS, Gordon D, Tchekmedyian S et al (2003) Zoledronic acid versus placebo in the treatment of skeletal metastases in patients with lung cancer and other solid tumors: a phase III, double-blind, randomized trial—the Zoledronic Acid Lung Cancer and Other Solid Tumors Study Group. J Clin Oncol 21:3150–3157

    Article  CAS  Google Scholar 

  35. Terpos E, Morgan G, Dimopoulos MA et al (2013) International Myeloma Working Group recommendations for the treatment of multiple myeloma-related bone disease. J Clin Oncol 31:2347–2357

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ramon Andrade De Mello .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Borges, A.M., Santos, A.J., Tadokoro, H., De Mello, R.A. (2019). Neoplasic Epidural Spinal Cord Compression. In: De Mello, R., Mountzios, G., Tavares, Á. (eds) International Manual of Oncology Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-16245-0_43

Download citation

Publish with us

Policies and ethics