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Metastatic spinal cord compression

Occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression

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Summary

We reviewed all medical records concerning patients suffering from spinal cord or cauda equina compression (SCC) secondary to cancer, in the eastern part of Denmark, from 1979 through 1985.

During the period the incidence of SCC in cancer patients went up from 4.4% to 6%. However, this increase was not significant.

The series comprised 398 cases, with carcinoma of the prostate (19%), lung (18%), breast (14%) and kidney (10%) accounting for 61%. The symptoms were evaluated in accordance with the patients rating of pain, motor deficits, sphincter control and paraesthesia, whereas the clinical manifestations were classified on the basis of motor deficit and bladder dysfunction. During the period preceding the diagnosis of SCC, 83% of the patients suffered from back pain, 67% from deteriorating gait and 48% had retention of the urine. In 35% of the patients there was no sphincter disturbance and 10% had normal sensory function.

The outcome of treatment was estimated by changes in motor deficits and sphincter function, and depended primarily on the patients condition at the time of the diagnosis. Of the patients who were able to walk before treatment, 79% remained ambulatory, wheras only 18% of the non-ambulatory patients regained walking ability. Patients treated by decompressive laminectomy followed by radiotherapy apparantly had a better response than patients treated with surgery or irradiation alone, but when the patients pre-treatment motor function was taken into account, no significant difference was observed.

The study may call for a properly randomized trial with careful stratification of tumour biology, performance status and neurological deficits.

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References

  1. Bansal S, Brady LW, Olsen Aet al (1967) The treatment of metastatic spinal cord tumors. JAMA 202: 686–688

    PubMed  Google Scholar 

  2. Barron KD, Hirano A, Araki Set al (1959) Experience with metastatic neoplasm involving the spinal cord. Neurology 9: 91–106

    PubMed  Google Scholar 

  3. Black P (1979) Spinal metastases: current status and recommended guidelines for management. J Neurosurg 5: 726–746

    Google Scholar 

  4. Brady LW, Antoniades J, Prasavinichai Set al (1975) The treatment of metastatic disease of the nervous system by radiation therapy. In: Seydl HG (ed) Tumors of the nervous system. John Whiley and Sons, New York, pp 176–189

    Google Scholar 

  5. Brice J, McKissock WS (1965) Surgical treatment of malignant extradural spinal tumours. Br Med J 1: 1341–1344

    Google Scholar 

  6. Chade HO (1976) Metastatic tumors of the spine and spinal cord. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology. 20. North-Holland publishing Co, Amsterdam, pp415–433

    Google Scholar 

  7. Cobb CA, Leavens ME, Eckles N (1977) Indications for nonoperative treatment of spinal cord compression due to breast cancer. J Neurosurg 47: 653–658

    PubMed  Google Scholar 

  8. Constans JP, Divitis ED, Donzelli Ret al (1983) Spinal metastases with neurological manifestations. Review of 600 cases. J Neurosurg 59: 111–118

    PubMed  Google Scholar 

  9. Dunn RC, Kelly WA, Wohns RNWet al (1980) Spinal epidural neoplasia. A 15-year review of the results of surgical therapy. J Neurosurg 52: 47–51

    PubMed  Google Scholar 

  10. Eldervik OP, Dugstad G, Orrison WWet al (1982) The effect of clinical bias of the interpretation of myelography and spinal computed tomography. Neuroradial 145: 85–89

    Google Scholar 

  11. Gilbert RW, Kim JH, Posner J (1978) Epidural spinal cord compression from metastatic tumour: diagnosis and treatment. Ann Neurol 3: 40–51

    PubMed  Google Scholar 

  12. Greenberg HS, Kim JH, Posner JB (1980) Epidural cord compression from epidural tumour: results with a new treatment protocol. Ann Neurol 8: 361–366

    PubMed  Google Scholar 

  13. Hall AJ, Mackay NNS (1973) The results of laminectomy for compression of cord and cauda equina by extradural malignant tumour. J Bone Joint Surg 55: 497–595

    Google Scholar 

  14. Hutchison JMS, Smith FW (1983) NMR clinical results: Aberdeen. In: Partain, James, Rollo, Price (eds) Nuclear magnetic resonance imaging. Saunders, Philadelphia, pp 231–249

    Google Scholar 

  15. Larsen SH, Rasmusson B, SØrensen PS (1989) Recovery of gait by radiotherapy in patients with spinal cord compression secondary to metastatic cancer. European Conference of Cancer and Clinical Oncology V. Proceedings, P-0482

  16. Livingston KE, Perrin RG (1978) The neurosurgical management of spinal metastases causing cord and cauda equina compression. J Neurosurg 3: 839–843

    Google Scholar 

  17. Nather A, Base K (1982) The results of decompression from metastatic extradural tumors. Clin Orthop 169: 103–108

    PubMed  Google Scholar 

  18. Pedersen AG, Bach F, Melgaard B (1985) Frequency, diagnosis and prognosis of spinal cord compression in small cell lung bronchogenic carcinoma. Cancer 55: 1818–1822

    PubMed  Google Scholar 

  19. Posner J (1971) Neurological complications of systemic cancer. Med Clin North Am 1971 55: 625–646

    Google Scholar 

  20. Rodichock LD, Ruckdeschel JC, Harper GRet al (1986) Early detection and treatment of spinal epidural metastases: the role of myelography. Ann Neurol 20: 696–702

    PubMed  Google Scholar 

  21. Shaw MDM, Rose JE, Paterson A (1980) Metastatic extradural malignancy of the spine. Acta Neurochir (Wien) 52: 113–120

    Google Scholar 

  22. Smith R (1965) An evaluation of surgical treatment for spinal cord compression due to metastatic carcinoma. J Neurol Neurosurg Psychiatry 28: 152–158

    PubMed  Google Scholar 

  23. Stark RJ, Henson RA, Evans SJW (1982) Spinal metastases. A retrospective survey from a general hospital. Brain 105: 189–213

    PubMed  Google Scholar 

  24. SØrensen PS, BØrgesen SE, Rohde Ket al (1990) Metastatic epidural spinal cord compression: results of treatment and survival. Cancer. 65: 1502–1508

    PubMed  Google Scholar 

  25. Tarlov M and Herz E (1954) Spinal cord compression studies. IV. Outlook with complete paralysis in man. A.M.A. Archives of Neurology and Psychiatry 72: 43–51

    PubMed  Google Scholar 

  26. Wild WO, Porter RW (1963) Metastatic tumour of the spine: a study of 45 cases. Arch Surg 87: 825–830

    PubMed  Google Scholar 

  27. Wright RL (1963) Malignant tumors in the spinal extradural space. Results of surgical treatment. Ann Surg 157: 227–231

    PubMed  Google Scholar 

  28. Young RF, Post EM, King GA (1980) Treatment of epidural metastases. Randomized prospective comparison of laminectomy and radiotherapy. J Neurosurg 53: 741–748

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Oncology, University Hospital Herlev, Denmark

    F. Bach

  2. Righospitalet, University Department of Neurology, Denmark

    B. H. Larsen & P. S. Sørensen

  3. The Finsen Institute, Denmark

    K. Rohde & B. Rasmusson

  4. Righospitalet, University Department of Neurosurgery, Denmark

    S. E. Børgesen, F. Gjerris & N. Agerlin

  5. Department of Neurosurgery, University Hospital Hvidovre, Denmark

    T. Bøge-Rasmussen

  6. Department of Neurosurgery, University Hospital Glostrup, Copenhagen, Denmark

    P. Stjernholm

Authors
  1. F. Bach
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  2. B. H. Larsen
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  3. K. Rohde
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  4. S. E. Børgesen
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  5. F. Gjerris
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  6. T. Bøge-Rasmussen
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  7. N. Agerlin
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  8. B. Rasmusson
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  9. P. Stjernholm
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  10. P. S. Sørensen
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Bach, F., Larsen, B.H., Rohde, K. et al. Metastatic spinal cord compression. Acta neurochir 107, 37–43 (1990). https://doi.org/10.1007/BF01402610

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