Malignant spinal cord compression

References

Key articles

Al-Qurainy R, Collis E. Metastatic spinal cord compression: diagnosis and management. BMJ. 2016 May 19;353:i2539. Abstract

Ruppert LM, Reilly J. Metastatic spine oncology: symptom-directed management. Neurooncol Pract. 2020 Nov;7(suppl 1):i54-i61.Full text  Abstract

American College of Radiology. ACR appropriateness criteria®: management of vertebral compression fractures. 2022 [internet publication].Full text

American College of Radiology. ACR appropriateness criteria®: low back pain. 2021 [internet publication].Full text  Abstract

American College of Radiology. ACR appropriateness criteria®: thoracic back pain. 2024 [internet publication].Full text

National Institute for Health and Care Excellence. Spinal metastases and metastatic spinal cord compression. Sep 2023 [internet publication].Full text

Alcorn S, Cortés ÁA, Bradfield L, et al. External beam radiation therapy for palliation of symptomatic bone metastases: an ASTRO clinical practice guideline. Pract Radiat Oncol. 2024 May 22:S1879-8500(24)00099-7.Full text  Abstract

Reference articles

1. Mechtler LL, Nandigam K. Spinal cord tumors: new views and future directions. Neurol Clin. 2013 Feb;31(1):241-68. Abstract

2. Ruppert LM. Malignant spinal cord compression: adapting conventional rehabilitation approaches. Phys Med Rehabil Clin N Am. 2017 Feb;28(1):101-14.Full text  Abstract

3. Yáñez ML, Miller JJ, Batchelor TT. Diagnosis and treatment of epidural metastases. Cancer. 2017 Apr 1;123(7):1106-14.Full text  Abstract

4. Bican O, Minagar A, Pruitt AA. The spinal cord: a review of functional neuroanatomy. Neurol Clin. 2013 Feb;31(1):1-18. Abstract

5. Spector LR, Madigan L, Rhyne A, et al. Cauda equina syndrome. J Am Acad Orthop Surg. 2008 Aug;16(8):471-9. Abstract

6. Kuris EO, McDonald CL, Palumbo MA, et al. Evaluation and management of cauda equina syndrome. Am J Med. 2021 Dec;134(12):1483-9. Abstract

7. Al-Qurainy R, Collis E. Metastatic spinal cord compression: diagnosis and management. BMJ. 2016 May 19;353:i2539. Abstract

8. Van Goethem JW, van den Hauwe L, Ozsarlak O, et al. Spinal tumors. Eur J Radiol. 2004 May;50(2):159-76. Abstract

9. Levack P, Graham J, Collie D, et al. Don't wait for a sensory level-listen to the symptoms: a prospective audit of the delays in diagnosis of malignant cord compression. Clin Oncol (R Coll Radiol). 2002 Dec;14(6):472-80. Abstract

10. Loblaw DA, Laperriere NJ, Mackillop WJ. A population-based study of malignant spinal cord compression in Ontario. Clin Oncol (R Coll Radiol). 2003 Jun;15(4):211-7. Abstract

11. Savage P, Sharkey R, Kua T, et al. Malignant spinal cord compression: NICE guidance, improvements and challenges. QJM. 2014 Apr;107(4):277-82.Full text  Abstract

12. Schiff D, O'Neill BP, Suman VJ. Spinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach. Neurology. 1997 Aug;49(2):452-6. Abstract

13. Caffarelli C, Santamaria F, Santoro A, et al. Best practices, challenges and innovations in pediatrics in 2019. Ital J Pediatr. 2020 Nov 30;46(1):176.Full text  Abstract

14. Lewis DW, Packer RJ, Raney B, et al. Incidence, presentation, and outcome of spinal cord disease in children with systemic cancer. Pediatrics. 1986 Sep;78(3):438-43. Abstract

15. Hammack JE. Spinal cord disease in patients with cancer. Continuum (Minneap Minn). 2012 Apr;18(2):312-27. Abstract

16. Bucholtz JD. Metastatic epidural spinal cord compression. Semin Oncol Nurs. 1999 Aug;15(3):150-9. Abstract

17. Sutcliffe P, Connock M, Shyangdan D, et al. A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression. Health Technol Assess. 2013 Sep;17(42):1-274.Full text  Abstract

18. Sciubba DM, Gokaslan ZL. Diagnosis and management of metastatic spine disease. Surg Oncol. 2006 Nov;15(3):141-51. Abstract

19. Boussios S, Cooke D, Hayward C, et al. Metastatic spinal cord compression: unraveling the diagnostic and therapeutic challenges. Anticancer Res. 2018 Sep;38(9):4987-97.Full text  Abstract

20. White AA 3rd, Johnson RM, Panjabi MM, et al. Biomechanical analysis of clinical stability in the cervical spine. Clin Orthop Relat Res. 1975;(109):85-96. Abstract

21. Raj VS, Lofton L. Rehabilitation and treatment of spinal cord tumors. J Spinal Cord Med. 2013 Jan;36(1):4-11.Full text  Abstract

22. Ullman TA, Itzkowitz SH. Intestinal inflammation and cancer. Gastroenterology. 2011 May;140(6):1807-16.Full text  Abstract

23. Kumar N, Tan WLB, Wei W, et al. An overview of the tumors affecting the spine-inside to out. Neurooncol Pract. 2020 Nov;7(suppl 1):i10-i17.Full text  Abstract

24. Cheng DT, Mitchell TN, Zehir A, et al. Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT): a hybridization capture-based next-generation sequencing clinical assay for solid tumor molecular oncology. J Mol Diagn. 2015 May;17(3):251-64.Full text  Abstract

25. Robinson DR, Wu YM, Lonigro RJ, et al. Integrative clinical genomics of metastatic cancer. Nature. 2017 Aug 17;548(7667):297-303.Full text  Abstract

26. Gralow JR, Biermann JS, Farooki A, et al. NCCN task force report: bone health in cancer care. J Natl Compr Canc Netw. 2009 Jun;7 Suppl 3:S1-32; quiz S33-5.Full text  Abstract

27. O'Carrigan B, Wong MH, Willson ML, et al. Bisphosphonates and other bone agents for breast cancer. Cochrane Database Syst Rev. 2017 Oct 30;(10):CD003474.Full text  Abstract

28. Bilsky M, Smith M. Surgical approach to epidural spinal cord compression. Hematol Oncol Clin North Am. 2006 Dec;20(6):1307-17. Abstract

29. Ruppert LM, Reilly J. Metastatic spine oncology: symptom-directed management. Neurooncol Pract. 2020 Nov;7(suppl 1):i54-i61.Full text  Abstract

30. UK Research and Innovation. MRC muscle scale. Jan 2022 [internet publication].Full text

31. American Spinal Injury Association. International standards for neurological classification of SCI (ISNCSCI) worksheet. 2019 [internet publication].Full text

32. Lees AJ, Hurwitz B. Testing the reflexes. BMJ. 2019 Aug 14;366:l4830. Abstract

33. Ropper AE, Ropper AH. Acute spinal cord compression. N Engl J Med. 2017 Apr 6;376(14):1358-69. Abstract

34. Consortium for Spinal Cord Medicine. Early acute management in adults with spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med. 2008;31(4):403-79.Full text  Abstract

35. Villanueva Herrero JA, Abdussalam A, Kasi A. Rectal exam. Treasure Island (FL): StatPearls Publishing; 2022.Full text

36. Fisher CG, DiPaola CP, Ryken TC, et al. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine (Phila Pa 1976). 2010 Oct 15;35(22):E1221-9. Abstract

37. Fourney DR, Frangou EM, Ryken TC, et al. Spinal instability neoplastic score: an analysis of reliability and validity from the spine oncology study group. J Clin Oncol. 2011 Aug 1;29(22):3072-7.Full text  Abstract

38. Pennington Z, Ahmed AK, Cottrill E, et al. Intra- and interobserver reliability of the Spinal Instability Neoplastic Score system for instability in spine metastases: a systematic review and meta-analysis. Ann Transl Med. 2019 May;7(10):218.Full text  Abstract

39. American College of Radiology. ACR appropriateness criteria®: management of vertebral compression fractures. 2022 [internet publication].Full text

40. Khasraw M, Posner JB. Neurological complications of systemic cancer. Lancet Neurol. 2010 Dec;9(12):1214-27. Abstract

41. American College of Radiology. ACR appropriateness criteria®: low back pain. 2021 [internet publication].Full text  Abstract

42. American College of Radiology. ACR appropriateness criteria®: thoracic back pain. 2024 [internet publication].Full text

43. Li KC, Poon PY. Sensitivity and specificity of MRI in detecting malignant spinal cord compression and in distinguishing malignant from benign compression fractures of vertebrae. Magn Reson Imaging. 1988 Sep-Oct;6(5):547-56.Full text  Abstract

44. Cook AM, Lau TN, Tomlinson MJ, et al. Magnetic resonance imaging of the whole spine in suspected malignant spinal cord compression: impact on management. Clin Oncol (R Coll Radiol). 1998;10(1):39-43. Abstract

45. Loblaw DA, Perry J, Chambers A, et al. Systematic review of the diagnosis and management of malignant extradural spinal cord compression: the Cancer Care Ontario Practice Guidelines Initiative's Neuro-Oncology Disease Site Group. J Clin Oncol. 2005 Mar 20;23(9):2028-37. Abstract

46. van der Sande JJ, Kröger R, Boogerd W. Multiple spinal epidural metastases; an unexpectedly frequent finding. J Neurol Neurosurg Psychiatry. 1990 Nov;53(11):1001-3.Full text  Abstract

47. National Institute for Health and Care Excellence. Spinal metastases and metastatic spinal cord compression. Sep 2023 [internet publication].Full text

48. Cole JS, Patchell RA. Metastatic epidural spinal cord compression. Lancet Neurol. 2008 May;7(5):459-66. Abstract

49. O'Sullivan GJ, Carty FL, Cronin CG. Imaging of bone metastasis: An update. World J Radiol. 2015 Aug 28;7(8):202-11.Full text  Abstract

50. Zhang L, Gong Z. Clinical characteristics and prognostic factors in bone metastases from lung cancer. Med Sci Monit. 2017 Aug 24;23:4087-94.Full text  Abstract

51. Karhade AV, Thio QCBS, Kuverji M, et al. Prognostic value of serum alkaline phosphatase in spinal metastatic disease. Br J Cancer. 2019 Mar;120(6):640-6.Full text  Abstract

52. Peitzsch C, Tyutyunnykova A, Pantel K, et al. Cancer stem cells: The root of tumor recurrence and metastases. Semin Cancer Biol. 2017 Jun;44:10-24. Abstract

53. Gao D, Mittal V, Ban Y, et al. Metastatic tumor cells - genotypes and phenotypes. Front Biol (Beijing). 2018 Aug;13(4):277-86.Full text  Abstract

54. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: central nervous system cancers [internet publication].Full text

55. Patel DA, Campian JL. Diagnostic and therapeutic strategies for patients with malignant epidural spinal cord compression. Curr Treat Options Oncol. 2017 Aug 10;18(9):53. Abstract

56. Abrahm JL, Banffy MB, Harris MB. Spinal cord compression in patients with advanced metastatic cancer: "all I care about is walking and living my life". JAMA. 2008;299(8):937–46. Abstract

57. Wong CC, McGirt MJ. Vertebral compression fractures: a review of current management and multimodal therapy. J Multidiscip Healthc. 2013;6:205-14.Full text  Abstract

58. Spratt DE, Beeler WH, de Moraes FY, et al. An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report. Lancet Oncol. 2017 Dec;18(12):e720-e730. Abstract

59. Kumar A, Weber MH, Gokaslan Z, et al. Metastatic spinal cord compression and steroid treatment: a systematic review. Clin Spine Surg. 2017 May;30(4):156-63. Abstract

60. George R, Jeba J, Ramkumar G, et al. Interventions for the treatment of metastatic extradural spinal cord compression in adults. Cochrane Database Syst Rev. 2015 Sep 4;(9):CD006716.Full text  Abstract

61. Skeoch GD, Tobin MK, Khan S, et al. Corticosteroid treatment for metastatic spinal cord compression: a review. Global Spine J. 2017 May;7(3):272-9.Full text  Abstract

62. L'espérance S, Vincent F, Gaudreault M, et al. Treatment of metastatic spinal cord compression: cepo review and clinical recommendations. Curr Oncol. 2012 Dec;19(6):e478-90.Full text  Abstract

63. Loblaw A, George KJ, Misra V. Surgical and radiotherapeutic management of malignant extradural spinal cord compression. Clin Oncol (R Coll Radiol). 2020 Nov;32(11):745-52. Abstract

64. Tokuhashi Y, Matsuzaki H, Oda H, et al. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 2005 Oct 1;30(19):2186-91. Abstract

65. Tomita K, Kawahara N, Kobayashi T, et al. Surgical strategy for spinal metastases. Spine (Phila Pa 1976). 2001 Feb 1;26(3):298-306. Abstract

66. Rich SE, Chow R, Raman S, et al. Update of the systematic review of palliative radiation therapy fractionation for bone metastases. Radiother Oncol. 2018 Mar;126(3):547-57. Abstract

67. Rades D, Šegedin B, Conde-Moreno AJ, et al. Radiotherapy with 4 Gy × 5 Versus 3 Gy × 10 for metastatic epidural spinal cord compression: final results of the SCORE-2 trial (ARO 2009/01). J Clin Oncol. 2016 Feb 20;34(6):597-602.Full text  Abstract

68. Alcorn S, Cortés ÁA, Bradfield L, et al. External beam radiation therapy for palliation of symptomatic bone metastases: an ASTRO clinical practice guideline. Pract Radiat Oncol. 2024 May 22:S1879-8500(24)00099-7.Full text  Abstract

69. Donovan EK, Sienna J, Mitera G, et al. Single versus multifraction radiotherapy for spinal cord compression: A systematic review and meta-analysis. Radiother Oncol. 2019 May;134:55-66. Abstract

70. Thirion PG, Dunne MT, Kelly PJ, et al. Non-inferiority randomised phase 3 trial comparing two radiation schedules (single vs. five fractions) in malignant spinal cord compression. Br J Cancer. 2020 Apr;122(9):1315-23.Full text  Abstract

71. Hoskin PJ, Hopkins K, Misra V, et al. Effect of single-fraction vs multifraction radiotherapy on ambulatory status among patients with spinal canal compression from metastatic cancer: the SCORAD randomized clinical trial. JAMA. 2019 Dec 3;322(21):2084-94.Full text  Abstract

72. Gerszten PC, Mendel E, Yamada Y. Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes? Spine (Phila Pa 1976). 2009 Oct 15;34(22 suppl):S78-92.Full text  Abstract

73. Redmond KJ, Lo SS, Soltys SG, et al. Consensus guidelines for postoperative stereotactic body radiation therapy for spinal metastases: results of an international survey. J Neurosurg Spine. 2017 Mar;26(3):299-306.Full text  Abstract

74. Guerrieri AN, Montesi M, Sprio S, et al. Innovative options for bone metastasis treatment: an extensive analysis on biomaterials-based strategies for orthopedic surgeons. Front Bioeng Biotechnol. 2020;8:589964.Full text  Abstract

75. Bakar D, Tanenbaum JE, Phan K, et al. Decompression surgery for spinal metastases: a systematic review. Neurosurg Focus. 2016 Aug;41(2):E2.Full text  Abstract

76. Hsieh MK, Bowles DR, Canseco JA, et al. Is open surgery for metastatic spinal cord compression secondary to lung cancer really beneficial? a systematic review. World Neurosurg. 2020 Dec;144:e253-e263. Abstract

77. Loblaw DA, Mitera G, Ford M, et al. A 2011 updated systematic review and clinical practice guideline for the management of malignant extradural spinal cord compression. Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):312-7.Full text  Abstract

78. Molina C, Goodwin CR, Abu-Bonsrah N, et al. Posterior approaches for symptomatic metastatic spinal cord compression. Neurosurg Focus. 2016 Aug;41(2):E11.Full text  Abstract

79. Bate BG, Khan NR, Kimball BY, et al. Stereotactic radiosurgery for spinal metastases with or without separation surgery. J Neurosurg Spine. 2015 Apr;22(4):409-15.Full text  Abstract

80. Health Quality Ontario. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: a systematic review. Ont Health Technol Assess Ser. 2016;16(11):1-202.Full text  Abstract

81. Basaran R, Kaner T. C5 nerve root palsy following decompression of cervical spine with anterior versus posterior types of procedures in patients with cervical myelopathy. Eur Spine J. 2016 Jul;25(7):2050-9. Abstract

82. Shou F, Li Z, Wang H, et al. Prevalence of C5 nerve root palsy after cervical decompressive surgery: a meta-analysis. Eur Spine J. 2015 Dec;24(12):2724-34. Abstract

83. Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012 Feb;141(2 suppl):e195S-e226S.Full text  Abstract

84. Menacho ST, Floyd C. Current practices and goals for mean arterial pressure and spinal cord perfusion pressure in acute traumatic spinal cord injury: Defining the gaps in knowledge. J Spinal Cord Med. 2021 May;44(3):350-6.Full text  Abstract

85. Toews I, George AT, Peter JV, et al. Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units. Cochrane Database Syst Rev. 2018 Jun 4;(6):CD008687.Full text  Abstract

86. Ginsberg DA, Boone TB, Cameron AP, et al. The AUA/SUFU guideline on adult neurogenic lower urinary tract dysfunction: treatment and follow-up. J Urol. 2021 Nov;206(5):1106-13.Full text  Abstract

87. Taweel WA, Seyam R. Neurogenic bladder in spinal cord injury patients. Res Rep Urol. 2015;7:85-99.Full text  Abstract

88. Emmanuel A. Neurogenic bowel dysfunction. 2019 Oct 28;8:F1000 Faculty Rev-1800.Full text  Abstract

89. Guo Y, Young B, Palmer JL, et al. Prognostic factors for survival in metastatic spinal cord compression: a retrospective study in a rehabilitation setting. Am J Phys Med Rehabil. 2003 Sep;82(9):665-8. Abstract

90. Kratzsch T, Piffko A, Broggini T, et al. Role of mTOR and VEGFR inhibition in prevention of metastatic tumor growth in the spine. Front Oncol. 2020;10:174.Full text  Abstract

91. Brook N, Brook E, Dharmarajan A, et al. Breast cancer bone metastases: pathogenesis and therapeutic targets. Int J Biochem Cell Biol. 2018 Mar;96:63-78. Abstract

92. Zheng GZ, Chang B, Lin FX, et al. Meta-analysis comparing denosumab and zoledronic acid for treatment of bone metastases in patients with advanced solid tumours. Eur J Cancer Care (Engl). 2017 Nov;26(6). Abstract

93. Alberta Health Services. Palliative radiotherapy: bone metastases and spinal cord compression. Jun 2016 [internet publication].Full text

94. Laufer I, Zuckerman SL, Bird JE, et al. Predicting neurologic recovery after surgery in patients with deficits secondary to MESCC: systematic review. Spine (Phila Pa 1976). 2016 Oct 15;41 Suppl 20:S224-S230.Full text  Abstract

95. Liu YH, Hu YC, Yang XG, et al. Prognostic factors of ambulatory status for patients with metastatic spinal cord compression: a systematic review and meta-analysis. World Neurosurg. 2018 Aug;116:e278-e290. Abstract

96. Zwicker JI, Furie BC, Furie B. Cancer-associated thrombosis. Crit Rev Oncol Hematol. 2007 May;62(2):126-36. Abstract

97. Tateiwa D, Oshima K, Nakai T, et al. Clinical outcomes and significant factors in the survival rate after decompression surgery for patients who were non-ambulatory due to spinal metastases. J Orthop Sci. 2019 Mar;24(2):347-52. Abstract

98. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016 Feb;149(2):315-52.Full text  Abstract

99. Raja AS, Greenberg JO, Qaseem A, et al. Evaluation of patients with suspected acute pulmonary embolism: best practice advice from the clinical guidelines committee of the American College of Physicians. Ann Intern Med. 2015 Nov 3;163(9):701-11.Full text  Abstract

100. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020 Jan 21;41(4):543-603.Full text  Abstract

101. National Institute for Health and Care Excellence. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. March 2020 [internet publication].Full text

102. Truong J, Ashurst JV. Pneumocystis Jirovecii Pneumonia. Treasure Island (FL): StatPearls Publishing; 2022 [internet publication].Full text  Abstract

103. Kirshblum S, O'Dell MW, Ho C, et al. Rehabilitation of persons with central nervous system tumors. Cancer. 2001 Aug 15;92(4 suppl):1029-38. Abstract

104. Groenen KHJ, van der Linden YM, Brouwer T, et al. The Dutch national guideline on metastases and hematological malignancies localized within the spine; a multidisciplinary collaboration towards timely and proactive management. Cancer Treat Rev. 2018 Sep;69:29-38.Full text  Abstract

Use of this content is subject to our disclaimer