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
CV (7)