Metastatic Spinal Cord Compression Flashcards
1
Q
What is MSCC?
A
Compression of the spinal cord +/- cauda equina as a result of malignant disease
2
Q
What is the mechanism of MSCC?
A
Collapse/compression of vertebral body with metastases
3
Q
What happens with cord compression?
A
Oedema
Venous congestion
Demyelination
4
Q
What can happen with prolonged compression?
A
Vascular injury
Cord necrosis
5
Q
What are the features of MSCC?
A
Back pain
- prolonged
- worse with straight leg raise
- worse with lying down
Limb weakness
Sensory deficits
Bladder/bowel dysfunction
6
Q
How is MSCC managed?
A
Dexamethasone 16mg
Surgery
Radiotherapy
7
Q
When should you not give dexamethasone in MSCC?
A
?Lymphoma
8
Q
How soon should an MRI be offered in pain suggesting MSCC?
A
Within 1 week
9
Q
How soon should an MRI be offered with signs of MSCC?
A
Within 24 hours
10
Q
How can MSCC be prevented?
A
Patient education if high risk
