Metastatic Spinal Cord Compression ( MSCC )

Malignant or Metastatic Spinal Cord Compression -occurs when the dural sac and its contents are compressed at the levels of the cord or cauda equina. This may be as a result of direct pressure , vertebral collapse or instability caused by metastatic spread or by direct extension of malignancy ( Scottish Palliative Care Guidelines )

How common ? True spinal emergency A delay in diagnosis can lead to irreversible loss of neurologic function Relatively common complication of cancer , occurring in 5-10 % of patients with malignancy , often complicating the end stage of patients life In 20-23 % of patients it can be the presenting feature of malignancy Most common tumours that metastasize to the spine are advanced breast , lung , prostate and kidney tumours Any systemic cancer including haematological malignancies can metastasise to the spine Spine is the most common osseous site for metastatic disease due to the inherent rich vascular supply and extensive lymphatic drainage Exact incidence is not known NICE guidance states approximately 4000 cases / year in England and Wales Average at diagnosis is 65 ( NICE )

How does it happen ? Haematogenous spread with bony metastasis to the vertebral spine causes collapse...