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Spinal–cord Compression

Spinal–cord Compression
Spinal–cord Compression


Spinal cord compression threatens mobility, independence and longevity in patients with metastatic cancer and may be the first presentation of curable malignancy in others. It most commonly occurs due to an enlarging vertebral metastasis encroaching on the epidural space or due to pathologic fracture of a vertebra infiltrated by malignancy

Signs and Symptoms

Diagnostic criteria



  • Pharmacological

    • Immobilising the patient and obtaining urgent MRI whole spine should be priorities.
    • Corticosteroids should be initiated on suspicion of cord compression.
    A: Dexamethasone IV 10 mg immediately followed by 16 mg daily in divided doses.
    • Bladder catheterisation is appropriate.
    • Once spinal cord compression is confirmed, urgent neurosurgical opinion should be sought.
    There are potential improvements in outcomes for patients treated with surgery upfront, though appropriateness for this will depend upon spinal stability, patient and malignancy related factors.
    • Radiotherapy: for patients who are not candidates for upfront surgery.
    • Palliative dose: 8Gy single fraction or 20Gy/5fr or 30Gy/10fr.

    Note: All patients suspicious for spinal cord compression should be referred to neurosurgeon and radiation oncologist as soon as possible.
  • Non-pharmacological


Updated on,

5 Novemba 2020 12:54:52



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