醫學筆記匯整 ED Notes

Malignant spinal cord compression

Up to 20% of cancer patients will develop neoplastic involvement of the vertebral column,
and 3-6% will develop spinal cord compression.

80% of patients with malignant spinal cord compression have a prior diagnosis of cancer.

Radiation therapy has been the typical treatment
for patients with malignant spinal cord compression,
beneficial response is seen in approximately 70% of those treated.

Outcome is highly dependent on pretreatment functional ability.

Consider surgery in highly selected cases, such as the following :
  - Patient in good general condition
    and able to undergo extensive surgery
  - Appropriate prognostic life expectancy
  - Rapidly progressive symptoms
  - Clinical worsening during radiotherapy
  - Unstable vertebral column

回想起 PGY 時期接過的病人
病人 Underly NPC 做過手術放療
這次診斷是Volvulus
做完大腸鏡decompression 後症狀緩解
急診半夜上病房

家屬卻提到這兩週以來
兩隻腳越來越沒力氣
越來越不能走 ....

Whole spine MRI :
multiple bone metastasis from C to L spine
With cord compression from T8-12 and L2.

所以 ～
遇到癌症病人背痛、下肢無力、失禁

這個診斷絕對不能忽略