Oncological emergencies (except neutropenic sepsis!) Spinal cord compression

ONCOLOGICAL EMERGENCIES (except neutropenic sepsis!)

Spinal cord compression

MRI features

• Compressed cord

Spinal cord compression

• An emergency.

• Under-recognised.

• May patients unnecessarily left paraplegic as early symptoms & signs not recognised by doctors.

Presenting symptoms in Scottish audit

• 95% pain.

• 85% weakness (median duration 20 days).

• only 18% walking at time diagnosis.

• 68% altered sensation.

• 56% urinary problems.

• 74% bowel problems (6% on strong opioids).

• 5% faecal incontinence.

Symptoms – description of pain

• Pain in spine (80%).

• Worse on coughing and straining.

• Frequently associated with radicular pain -band like burning pain sometimes with hypersensitivity – precedes weakness.

Symptoms -others

• Weakness – bi-lateral or unilateral.

• Sensory changes can be loss of one or all of:

• Proprioception.
• Light touch.
• Pin-prick.
•