Spinal cord compression is an oncological emergency and affects up to 5% of cancer patients. It is more common in patients with lung, breast and prostate cancer

Aetiology

They can be primary (osteoid, cartilaginous, Lymphoproliferative, notochordal origin, round cell tumour)

Secondary:

• Spinal metastases are the most common tumours of the spine - Prostate, breast, lung, renal, gastric
• Approximately 30% of patients with cancer develop symptomatic spinal mets during their illness.
• Up to 90% has metastatic spinal lesions at the time of their death.

Tumour can be intradural or extradural (more commonly extradural)

PC

Malignant or metastatic disease - Systemic Sx (weight loss, malaise) more common then in benign lesions

Slow onset of Sx

Most frequent and earliest Sx (benign or malignant) - back pain:

• Extradural - aggravated by coughing/straining
• May be radicular, localised or felt generally in an extremity

May have neurological deficits secondary to cord compression:

• Can range from slight weakness - abnormal reflex - complete paraplegia
• Loss of bowel/bladder continence
• Motor deficits, parasthesia, numbness, loss of sphincter control