Red Flags in metastatic spinal cord compression

A user-friendly list of metastatic spinal cord compression Red Flags for clinicians working in primary-care

Cancer is the second most common cause of death in the United Kingdom. Metastases to the spinal column occur in 3–5% of all patients with cancer, most commonly those with breast, prostate and lung cancer, in whom the incidence may be as high as 19%. In total, there are +/- 4000 cases of metastatic spinal cord compression (MSCC) in England and Wales each year.

Pathological vertebral body collapse or direct tumour growth cause compression of the spinal cord, leading to irreversible neurological damage. In addition to the agonising pain and spinal instability, compression on the spinal cord can also lead to paraplegia or quadriplegia and double incontinence.

At diagnosis, 82% of patients with MSCC are unable to walk or only able to do so with help. The development of paraplegia and loss of control of bladder and bowel function have a devastating effect on the quality of life that remains and considerably reduce life expectancy.

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