Malignant spinal cord compression: Difference between revisions

(Created page with "==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) *...")
 
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##Consider starting in ED if imaging is delayed
##Consider starting in ED if imaging is delayed
#Radiotherapy (emergent)
#Radiotherapy (emergent)
==See Also==
[[Spinal Cord Compression (Non-Traumatic)]]


==Source==
==Source==
Tintinalli
Tintinalli


[[Source:Heme/Onc]]
[[Category:Heme/Onc]]

Revision as of 04:53, 24 November 2011

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

Treatment

  1. Corticosteroids
    1. Dexamethasone 10mg IV followed by 4mg PO or IV q6hr
    2. Consider starting in ED if imaging is delayed
  2. Radiotherapy (emergent)

See Also

Spinal Cord Compression (Non-Traumatic)

Source

Tintinalli