Workup/Staging Flashcards
Describe the workup of cord compression.
Cord compression workup: H&P with careful attention to complete neurologic exam to include DRE, evaluation of sensation to determine level of the lesion, assessment of pain, prior cancer management to include prior RT, assessment of bowel/bladder function, and screening MRI of the full cervical/thoracic/lumbar (C/T/L) spine
Why is a screening MRI of the spine ordered to evaluate cord compression?
Pts with suspected cord compression should be evaluated with a screening MRI of the full C/T/L spine b/c multilevel involvement is not uncommon.
Is a gadolinium-enhanced MRI necessary to evaluate cord compression?
No, it is not required to diagnose epidural compression. Contrast improves identification of leptomeningeal and intramedullary mets.
Why is CT useful in evaluating cord compression?
CT evaluation of SC compression helps to delineate osseous structures, including retropulsed fragments, and aids in surgical planning.
