Spinal cord compression

Question 1

management of spinal cord compression ?

Answer 1

dexamethasone

urgent oncological assessment for consideration of radiotherapy or surgery

Question 2

features of spinal cord compression ?

Answer 2

back pain (first symptom)
- worse when lying down and coughing 

lower limb weakness
lower limb sensory changes
neurological signs
- if above L1 = UMN
- if below L1 = LMN and perianal numbness
tendon reflexes are absent at the lesion and increased below the level of the lesion

Question 3

what primary cancers is spinal cord compression most common in ?

Answer 3

lung
breast
prostate

Question 4

if there are symptoms of spinal metastasis but no neurological symptoms, what would you do ?

Answer 4

arrange whole spinal MRI within 1 week

if neurological symptoms then most likely spinal cord compression so urgent MRI within 24 hours