Malignant spinal cord compression: Difference between revisions
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m (Rossdonaldson1 moved page Malignant Spinal Cord Compression to Malignant spinal cord compression) |
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Revision as of 22:26, 4 March 2015
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