Malignant Spinal Cord Compression (MSCC) Flashcards
What are the 2 main causes of MSCC?
Vertebral collapse
Extradural metastases
What part of the spine is most commonly affeced by MSCC?
Thoracic spine
What investigation needs to be done uregntly is MSCC is suscpted?
MRI
What does MSCC commonly present as?
Back pain
Neruopathy (dermatomal)
Progressive leg weakness
Sensory loss
Urinary & fecal incontinence
What type of spread occurs by neropathy as a result of MSCC?
Dermatomal spread
What are some of the likely clinical signs of MSCC?
Tenderness over affected area
Reduced power & sensation in legs
Reduced anal tone
What exmaniations should be done for MSCC and what should you check for?
Neurological -> check power and sensation in legs
PR -> check anal tone
What is the gold-standard investigation for MSCC?
MRI
What investigation is done if a MRI can’t be done and give an example of when it will be indicated?
CT
Done if there was a pacemaker (MRI would bugger it)
What should you check for in bloods for MSCC?
Ca
FBC
CRP
PSA
Why should you check PSA levels in a man with MSCC?
As prostate cancer may be a cause
How is MSCC treated?
Supportive
Dexmatheasone
Omeprazole
Surigcal deompression
Radiotherapy (targeted)
Chemotherapy
What cancers are mainly associated with MSCC?
Breast
Bronchus
Prostate
Kidneys
Myeloma
What 2 scores can be done to check if surgery is needed for spinal issues?
SINS
Tokushaki score
