Surgical and Radiotherapeutic Management of Malignant Extradural Spinal Cord Compression.
Clin Oncol (R Coll Radiol)
; 32(11): 745-752, 2020 11.
Article
in En
| MEDLINE
| ID: mdl-32828635
ABSTRACT
Malignant spinal cord compression is one of the most dreaded complications of advanced malignancy, with patients presenting with progressive paralysis, paresthesia and/or autonomic dysfunction. The choice of management should be guided by the expected prognosis and outcome, not just from a neurological function point-of-view but also from the metastatic cancer itself. The main indications for surgery are impending cord compression, spinal instability from tumour progression, bony retropulsion, for tissue diagnosis and for pain resistant to conventional therapies. Here, surgical principles, traditional and novel techniques and complications will be reviewed. For radiotherapy, multiple randomised studies have shown that for most patients a single fraction of external radiation has the same functional outcomes compared with multi-fractionation protocols. The experience of a specialised centralised interdisciplinary team will also be discussed.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord Compression
/
Spinal Cord Neoplasms
Type of study:
Clinical_trials
/
Guideline
/
Prognostic_studies
Aspects:
Patient_preference
Limits:
Humans
Language:
En
Journal:
Clin Oncol (R Coll Radiol)
Year:
2020
Document type:
Article