Referral criteria from primary care - suspected metastatic (mets) spinal cord compression (MSCC)

Early detection of metastatic spinal cord compression:

• contact the metastatic spinal cord compression (MSCC) coordinator urgently (within 24 hours) to discuss the care of patients with cancer and any of the following symptoms suggestive of spinal metastases:
  • pain in the middle (thoracic) or upper (cervical) spine
  • progressive lower (lumbar) spinal pain
  • severe unremitting lower spinal pain
  • spinal pain aggravated by straining (for example, at stool, or when coughing or sneezing)
  • localised spinal tenderness
  • nocturnal spinal pain preventing sleep
• contact the MSCC coordinator immediately to discuss the care of patients with cancer and symptoms suggestive of spinal metastases who have any of the following neurological symptoms or signs suggestive of MSCC, and view them as an oncological emergency:
  • neurological symptoms including radicular pain, any limb weakness, difficulty in walking, sensory loss or bladder or bowel dysfunction
  • neurological signs of spinal cord or cauda equina compression

Reference:

• 1. NICE (November 2008). Diagnosis and management of adults at risk of and with metastatic spinal cord compression.