Metastatic Spinal Cord Compression Flashcards
Why is Cauda equina often mention with MSCC? (2 points)
- They have similar pathophysiological processes
- So CE caused by cancer is a subtype of MSCC
What percentage of cancer pt will develop Metastatic lesions affecting Spinal Cord?
5-10%
What is the causes of MSCC? (3 things)
- Secondary to metastatic deposits within spinal column (most common)
- Secondary to Mechanical dysf (structural weakness bc other cancer)
- Primary CNS tumours
What are the cancers that most commonly cause MSCC? (5 things)
- Lung cancer
- Breast cancer
- Kidney cancer
- Prostate cancer
- Thyroid cancer
Where in the spine does MSCC usually happen?
1. Thoracic spine (60%)
2. Lumbar spine (30%)
3. Cervical spine (10%)
What are the CF of MSCC? (5 things)
- Back pain (95%)
- Weakness (symmetrical) (85%)
- Sensory symptoms
- Sphincter dysf
- Cauda equina syndrome (if CE part of spine affected)
When is the Back pain in MSCC worse?
@ coughing / straining
How does Sphincter dysf in MSCC present? (2 things)
- Urinary retention / incontinence
- Faecal incontinence
What is the GOLD standard investigation for MSCC Dx?
MRI
What is the use of MRI in MSCC Dx? (2 things)
- Accurate identification of compression site
- Can determine extent of disease
What is important about investigating sus MSCC?
It is an oncological emergency, needs rapid investigation + Mx
What are the General Initial Mx options for MSCC? (3 things)
- Analgesia
- VTE prophylaxis (bc cancer = VTE risk)
- Catheter (if any bladder dysf)
What are the VTE prophylaxis options for MSCC pt? (2 things)
- TED stockings
- Prophylactic LMWH
What is a more specific Initial Mx option for MSCC?
Dexamethasone (high dose)
What is the use of Dexamethasone in MSCC Mx?
Reduces oedema –> relieves compression