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spinal cord compression due to mets

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Spinal cord compression is characterised by a combination of a progressive history of neurological deficit and a sensory level on examination.

This is a lesion that causes lower motor neurone signs at the level of the lesion and upper motor neurone lesions below that level.

It is a neurological emergency because:

  • the final events are ischaemic, so they are fast and irreversible
  • the patient may be left in a wheelchair, incontinent of urine

Note that the commonest cause of acute cord compression is metastatic disease.

Notes:

  • true incidence of metastatic spinal cord compression in England and Wales is unknown because cases are not systematically recorded. However, evidence from an audit carried out in Scotland between 1997 and 1999 and from a published study from Canada, suggests that the incidence may be up to 80 cases per million people every year. This equates to approximately 4000 cases each year in England and Wales, or more than 100 cases per cancer network each year

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