Oncologic Emergencies Dr Karenza Alexis

Spinal Cord Compression

• Diagnosis- image the ENTIRE spine

• Xray
• 66% will have bony abnormalities
• Erosion, loss of pedicles, vertebral body collapse, paraspinous soft tissue mass
• Cannot exclude epidural mets
• Does not exclude cord compression if normal
• Follow-up with MRI
• MRI
• STANDARD!!!!!!!
• CT scan

Spinal Cord Compression

• Goal of treatment:

• recovery and maintenance of normal neurological function,
• stabilization of the spine
• Local tumor control
• pain control

• Treatment Outcome:

• Degree of neurologic impairment
• Radiosensitivity of tumor

Spinal Cord Compression

• Treatment:
• Steroids
• START DEXAMETHASONE IMMEDIATELY if you suspect cord compression
• 10 mg IVP followed by 4 mg IV every 6 hours (higher doses be used if patient presents with significant neurological impairment)
• Radiation
• Stable spine with radiosensitive tumors, non-surgical candidates with spinal instability,
• Port includes area of epidural involvement plus two vertebral bodies above and below