Neoplastic spinal cord compression

Question 1

Most common cause of neoplastic spinal cord compression

Answer 1

Extradural compression from vertebral body metastases

Question 2

In what cancers is spinal cord compression most common?

Answer 2

lung
breast
prostate cancer

Question 3

Clinical features of spinal cord compression

Answer 3

• back pain
  (worse on lying down/coughing)
• lower limb weakness
• sensory loss and numbness

Lesions above L1
- UMN signs in legs

Lesions below L1
- LMN signs in legs
- perianal numbness

Tendon reflexes increased below level of lesion and absent at level of lesion

Question 4

Gold standard investigation

Answer 4

MRI spine whole

Question 5

Management of neoplastic spinal cord compression

Answer 5

• high-dose oral dexamethasone
• consideration of radiotherapy or surgery