Spinal metastases

Spinal metastases

Patients may present with spinal metastases before developing metastatic spinal cord compression. It is, therefore, important to detect these patients early before any neurological compromise develops.

Symptoms and findings

• Unrelenting lumbar back pain
• Any thoracic or cervical back pain
• Worse with sneezing, coughing or straining
• Nocturnal
• Associated with tenderness

If any neurological features are present then spinal cord compression must be suspected and acted on promptly. Without neurological features, a whole spine MRI should be completed within one week. The whole spine should be imaged as patients commonly present with multi-level disease.

Sources:
Al-Qurainy, Rasha, and Emily Collis. 'Metastatic Spinal Cord Compression: Diagnosis and Management.' Bmj (2016): I2539.

Metastatic Spinal Cord Compression in Adults: Risk Assessment, Diagnosis and Management Clinical Guideline [CG75]. National Institute of Clinical Excellence. N.p., Nov. 2008.

+PassMedicine Notes

Patients may present with spinal metastases before developing metastatic spinal cord compression. It is, therefore, important to detect these patients early before any neurological compromise develops.

Symptoms and findings

• Unrelenting lumbar back pain
• Any thoracic or cervical back pain
• Worse with sneezing, coughing or straining
• Nocturnal
• Associated with tenderness

If any neurological features are present then spinal cord compression must be suspected and acted on promptly. Without neurological features, a whole spine MRI should be completed within one week. The whole spine should be imaged as patients commonly present with multi-level disease.

Sources: Al-Qurainy, Rasha, and Emily Collis. 'Metastatic Spinal Cord Compression: Diagnosis and Management.' Bmj (2016): I2539.

Metastatic Spinal Cord Compression in Adults: Risk Assessment, Diagnosis and Management Clinical Guideline [CG75]. National Institute of Clinical Excellence. N.p., Nov. 2008.