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Recognising Metastatic Spinal Cord Compression and Treatment
  1. Dr Helen Morgan, Specialist Registrars in Palliative Medicine and
  2. Dr Declan Cawley, Specialist Registrars in Palliative Medicine
  1. The Christie NHS Foundation Trust, Manchester. Email: helen.morgan2{at}christie.nhs.uk

Abstract

Recognising metastatic spinal cord compression (MSCC) and knowledge of its management are important skills for health professionals, including nurses, working within palliative and end-of-life care. Metastases to the spine occur in about 3–5% of all patients with cancer, with 10% of these patients developing spinal cord compression. MSCC is considered an emergency because the consequences, if missed, are severely debilitating, resulting in irreversible paralysis and loss of sphincter function. This article will review the epidemiology, incidence, diagnosis and management of MSCC. It will focus particularly upon the recent guidance on MSCC from the National Institute for Health and Clinical Excellence. The key finding is that, although a relatively uncommon condition, MSCC has serious implications for the patient if missed. However, diagnosis is often delayed. A high index of suspicion should exist in at-risk cancer patients, i.e. those with multiple myeloma and cancers of the breast, prostate and lung. Conflicts of interest: None

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