Extradural spinal cord compression: analysis of factors determining functional prognosis--prospective study.

Abstract

The treatment results in 59 patients with extradural spinal cord compression (ESCC) who were treated with irradiation between April 1987 and December 1988 were analyzed prospectively. Eighty percent of the patients presented with back pain, which preceded ESCC by an average of 6 weeks. The most common primary tumor was lung cancer (27% of cases), followed by prostate cancer and breast cancer. The prognostic significance of pretreatment motor function, degree of spinal cord block, radiosensitivity of tumor, and radiation dose schedule was determined with multivariate analysis. Only pretreatment motor function was found to be a significant factor in determining functional prognosis (P = .0058). Even with the increasing clinical awareness of ESCC, 78% of the patients in the current series were nonambulatory at presentation. Therefore, computed tomographic myelography or magnetic resonance imaging is recommended for patients with back pain and bone destruction at the site of the complaint if local radiation treatment is not planned.

Traumatic vs non-traumatic spinal cord lesions: comparison of neurological and functional outcome after in-patient rehabilitation

“…Spinal tumors, which were the next most common etiology in non-traumatic group in this study, involve the thoracic and lumbar regions more than cervical regions. [13][14][15] Contrary to the earlier study by Mckinley et al 1 in 2000 recording significant age difference of traumatic SCL with neoplastic SCL, no significant age difference was found in this study between both the groups (P40.05), as the mean age was 32.86±7.95 years in traumatic group and 31.10 ± 14.35 years in non-traumatic SCL group. It can be explained on the basis that in this study most of the neoplastic spinal tumors were primary, afflicting the patient at much earlier age compare with secondary metastasis, which is a late phenomenon.…”

Prognostic factors for functional outcome and survival after reirradiation for in‐field recurrences of metastatic spinal cord compression

“…and of the ambulatory status before radiotherapy have been previously described for the first course of RT for MSCC. 12,[20][21][22][23] The time to development of motor deficits before radiotherapy is also associated with motor function. 12,24 A slower development of motor deficits (>14 days) represents a slower growing lesion.…”

Diagnosis and Management of Central Nervous System Metastases from Breast Cancer

“…The thoracic 405 CNS Metastases from Breast Cancer spine is most commonly involved in cases of spinal metastasis. The principal symptom of spinal metastasis is pain, which may be local, radicular, or referred, and precedes other symptoms by a mean of 6 weeks [77]. Isolated back pain without neurologic symptoms should be evaluated first with plain spine radiographs.…”