Cord Compression
Background
What % of cancer pts develop cord compression?
5%–10% of cancer pts develop cord compression.
What are 3 routes of metastatic spread to the spine?
Routes of metastatic spread to the spine: hematogenous, direct extension, and CSF. (Abeloff MD et al., Abeloff’s clinical oncology. 4th ed. 2008)
What malignancies commonly cause cord compression?
Cancers that commonly cause cord compression include lung, breast, prostate, renal cell, lymphoma, and multiple myeloma.
How do pts with cord compression present?
Presenting Sx of cord compression: back pain, radicular pain, weakness, altered sensation, bowel/bladder dysfunction, and paralysis
What is the most common presenting Sx of cord compression?
The most common Sx of cord compression is back pain.
What part of the vertebra is most commonly involved by metastatic Dz?
Metastatic Dz typically involves the vertebral body rather than the post elements.
What part of the spine is most often involved in cord compression?
The thoracic spine is most commonly affected by cord compression.
Workup/Staging
Describe the workup of cord compression.
Cord compression workup: H&P with careful −attention to complete neurologic exam, evaluation of sensation to determine level of the lesion, assessment of pain, assessment of bowel/bladder function, and screening MRI 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 spine b/c −multilevel involvement is not uncommon.
Why is CT useful in evaluating cord compression?
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