Oncological emergencies (except neutropenic sepsis!) Spinal cord compression



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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.

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