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Metastatic Spinal Cord Compression

  • John W. CrommettEmail author
Reference work entry

Abstract

Metastatic spinal cord compression is a medical emergency characterized by its potential for rapid deterioration of neurological function, often leading to significant impairments in quality of life. The most common mechanism is growth of a vertebral metastatic lesion with invasion of the epidural space and compression of the spinal cord. Patients commonly present with progressive pain and may later develop motor and sensory weakness, and autonomic dysfunction. The preferred imaging study is an MRI of the entire spine, which should be performed urgently. In patients without known malignancy, tissue diagnosis through biopsy as well as evaluation for primary site of disease and other metastases is necessary. Initial management includes steroids and analgesics. Treatment options include radiation and surgical decompression, and considerations include tissue type, an assessment of spinal stability, and performance status. Patients with metastatic spinal cord compression should be managed at centers capable of providing specialized treatment including radiation oncology and neurosurgery.

Keywords

Metastatic spinal cord compression Vertebral metastasis Intramedullary Corticosteroids Dexamethasone Magnetic resonance imaging Surgical decompression Stereotactic radiation Cancer Radiotherapy Tetraplegia Paraplegia 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Critical Care MedicineThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

Section editors and affiliations

  • Yenny Cardenas
    • 1
  1. 1.Critical Care DepartmentUniversidad del Rosario Hospital Universitario Fundacion Santa Fe deBogotaColombia

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