Metastatic Spinal Cord Compression: A Prospective Observational Study at a Tertiary Care Center of North India

Abstract

Introduction: Metastatic spinal cord compression (MSCC) is a most commonly encountered emergency in oncology, that can lead to permanent paraplegia if left untreated or treatment delayed, so it is essential to diagnose early and treat aggressively to preserve or improve the patient’s quality of life. We analyzed the incident and the effect of common interventions on the outcome in these patients. Material and Methods: We prospectively evaluated 80 patients of MSCC without any intervention in the year 2017 and collected all relevant patient and disease characteristics. All patients received corticosteroids. Seven patients were operated, 59 patients treated by radiotherapy and 3 patients were treated by surgery followed by radiotherapy. Results: Most of the patients were in the age group of 40-70 years with male gender preponderance. Lung cancer was the most common incident (46.25%) malignancy followed by breast, myeloma and prostate cancer. Dorsal spine was the most common site of compression (50.5%) followed by lumbar spine (40.8%) and cervical spine (8.7%). 62 (77.5%) patients were presented with pain at affected site and 60 (75%) were presented with neurological motor deficit. 54 (87%) patients got relieved from pain and only 23(38%) patients had motor improvement after treatment. Conclusion: Patients presented 7-10 days after onset of neurological deficit were associated with poor outcome in neurological function, but radiotherapy proved an important modality for pain relief in MSCC and also beneficial in motor function preservation if instituted early. before predictive of response to treatment and overall outcome of motor functions.