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Compressão maligna da medula espinhal

Последний просмотренный: 12 Dec 2025
Last updated: 01 Apr 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • diagnóstico de câncer conhecido
  • ≥40 anos de idade
  • dorsalgia
  • fraqueza ou paralisia
  • dormência ou parestesias
  • perda sensitiva
  • hiper-reflexia e Babinski ou reflexos associados
  • disfunção da bexiga ou do intestino
Полная информация

Другие диагностические факторы

  • síndrome da cauda equina
  • Síndrome de Brown-Sequard
Полная информация

Факторы риска

  • tipo de tumor e metástases
  • distúrbios do sistema imunológico
  • exposição à radiação
  • características genotípicas
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • RNM da coluna com realce de gadolínio
  • RNM da coluna vertebral
  • mielotomografia
Полная информация

Исследования, проведение которых нужно рассмотреть

  • tomografia computadorizada (TC) da coluna vertebral
  • radiografia
  • cintilografia óssea
  • tomografia por emissão de pósitrons (PET)
  • biópsia do tumor e histopatologia
  • cálcio sérico
  • fosfatase alcalina sérica
  • exames laboratoriais específicos para câncer
  • marcadores de células-tronco cancerígenas
Полная информация

Алгоритм лечения

Острый

todos os pacientes

Составители

Авторы

Kenneth F. Casey, MD, FACS

Clinical Associate Professor Surgery (Neurosurgery)

Michigan State University

Clinical Associate Professor (Physical Medicine and Rehabilitation)

Wayne State University School of Medicine

Detroit

MI

Раскрытие информации

KFC declares that he has no competing interests.

Lisa M. Ruppert, MD

Associate Attending Physiatrist

Department of Neurology-Rehabilitation Medicine Service

Memorial Sloan Kettering Cancer Center

Assistant Professor

Department of Rehabilitation Medicine

Weill Cornell Medical Center

New York

NY

Раскрытие информации

LMR is an author of references cited in this topic.

Рецензенты

Marcin Czyz, MD, PhD

Consultant Spine Neurosurgeon

Department of Neurosurgery

University Hospitals Birmingham NHS Trust

Birmingham

UK

Раскрытие информации

MC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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

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

American College of Radiology. ACR appropriateness criteria®: low back pain. 2021 [internet publication].Полный текст  Аннотация

American College of Radiology. ACR appropriateness criteria®: thoracic back pain​. 2024 [internet publication].Полный текст

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.Полный текст  Аннотация

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

Статьи, указанные как источники

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