Malignant spinal cord compression: Difference between revisions
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*MRI: modality of choice | *MRI: modality of choice | ||
*CT myelography: use if MRI unavailable | *CT myelography: use if MRI unavailable | ||
*Metastatic Bone Cancers | |||
**BTL w/ Pickles and Relish: Breast, Thyroid, Lung, Prostate, Renal | |||
==Treatment== | ==Treatment== | ||
Revision as of 02:25, 30 December 2014
Background
- Suspect in pt w/ known cancer (esp lung, breast, prostate) + back pain
- Occurs in thoracic location in 70% of pts
Clinical Features
- Back pain (90% of pts)
- Progressive and worse when supine
- Motor weakness (proximal legs)
- Sensory changes and bladder or bowel dysfunction (late findings)
Diagnosis
- MRI: modality of choice
- CT myelography: use if MRI unavailable
- Metastatic Bone Cancers
- BTL w/ Pickles and Relish: Breast, Thyroid, Lung, Prostate, Renal
Treatment
- Corticosteroids
- Dexamethasone 10mg IV followed by 4mg PO or IV q6hr
- Consider starting in ED if imaging is delayed
- Radiotherapy (emergent)
See Also
Spinal Cord Compression (Non-Traumatic)
Source
Tintinalli