Spinal Cord Neoplasms Treatment & Management

Updated: Jul 17, 2019
  • Author: Jesse Borke, MD, FACEP, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Treatment

Prehospital Care

Use of spinal immobilization precautions is prudent when neurologic impairment is suggested. 

Support airway, breathing, and circulation during transport.

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Emergency Department Care

Spinal cord compression secondary to cancer is an emergency that requires rapid diagnosis and treatment to prevent permanent complications. Even when a cure is not possible, timely diagnosis and treatment may improve the patient's quality of life.

In cancer patients with clinical suspicion of spinal cord compression, dexamethasone should be initiated. This should be followed promptly by surgical decompression, when possible, and radiation therapy. [7]  See Follow-up: Further Inpatient Care.

A Cochrane review found a lack of evidence-based guidance around how to correctly position and when to mobilize patients with metastatic spinal cord compression, and whether spinal bracing is effective for reducing pain or improving quality of life. Caution should be used, as mobilization may be hazardous in the presence of spinal instability; further vertebral collapse can occur. [8]  

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Consultations

Neurosurgeons traditionally manage spinal cord compression and dysfunction; however, local practices may vary. Oncology, neurology, and radiation oncology staff may be involved in some circumstances.

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