Management of Metastatic Spinal Cord Compression

Subspecialty: Spine

Type: Clinical Summary

Metastatic spinal disease and metastatic epidural spinal cord compression (MESCC) arise when vertebral or epidural tumour growth causes mechanical compression and biologic injury to the spinal cord; the acute pathophysiology includes oedema, venous congestion and demyelination that may be reversible if relieved early, while prolonged compression produces secondary vascular injury and infarction with irreversible loss. This combined summary integrates the randomised trial by Patchell et al. (Lancet 2005) that tested direct decompressive surgery plus radiotherapy versus radiotherapy alone, the W…

Source Papers

Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial (2005)
Complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors: WFNS spine committee recommendations (2024)
Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression—A New Integrative Flowchart for Patient Management (2023)
The NOMS framework: approach to the treatment of spinal metastatic tumors. (2013)