Metastatic Spinal Cord Compression

According to recent Canadian statistics, an estimated 186,400 new cases of cancer and 75,700 deaths from cancer are expected in Canada in 20121. In general, between 40% and 70% of patients with advanced solid tumours such as those of breast, prostate, and lung will develop bone metastases2. The spine is the most common site for bone metastasis, affecting up to 30% of cancer patients3. Overall, between 5% and 10% of cancer patients will develop metastatic spinal cord compression (mscc), an oncologic emergency requiring early diagnosis and immediate treatment4,5. Spinal cord damage including vascular injury, hemorrhage, white matter edema, and nerve damage such as demyelination and axonal damage, are frequently observed at the site of compression and cause symptoms such as back pain and motor or sensory deficits6–9. The main objectives of mscc treatment are preservation or improvement of neurologic function (particularly walking capacity), pain relief, and preservation or improvement of quality of life7. The most-used treatment modalities are corticotherapy, radiotherapy, and surgery. ABSTRACT