PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 15102344

Metastatic epidural cord compression.

Thomas N Byrne
View original source ↗Export metadata ↓

Abstract

The past few years have witnessed remarkable advances in spinal imaging, radiosurgery, and minimally invasive procedures, such as vertebroplasty and kyphoplasty, as well as improved spinal surgical options with stabilization through instrumentation. These advances provide opportunities to treat patients with vertebral metastases and metastatic epidural spinal cord compression (MESCC) more successfully. In addition, a new study demonstrates that the time to develop motor weakness is an independent prognostic factor in outcome in patients with MESCC. These advances are reviewed.

Explore related subjects

Epidural NeoplasmsHumansSpinal Cord CompressionJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Thomas N Byrne. 2004. Metastatic epidural cord compression.. https://doi.org/10.1007/s11910-004-0038-0

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Epidural extension of a lumbar vertebral haemangioma.

Vertebral haemangiomas are relatively common, but those extending into the epidural space are rare. A 59-year-old man with severe lower back and right leg pain that did not resolve with conservative treatment was seen in an outpatient clinic. Magnetic resonance imaging of the lumbar spine identified an L3 vertebral corpus lesion with epidural extension. The diagnosis was unclear, so the patient underwent surgery. The pathologic diagnosis was capillary haemangioma, so angiography-guided embolization was performed postoperatively. Vertebral haemangioma must be considered when there is evidence of a vertebral corpus lesion with epidural extension on magnetic resonance imaging.

Epidural Neoplasms↗
PubMed2006

Metastatic epidural spinal cord compression: update on management.

Until recently, patients with metastatic epidural spinal cord compression (MESCC) were routinely treated with corticosteroids and radiotherapy (RT). However, major advances in imaging, recognition of new prognostic factors, and new techniques in RT and surgery have led to a number of management choices that need to be considered when treating a patient with MESCC. In our view, the management should be individualized taking into account many variables. We present here some of the advances we believe are among the most important. A historical background to the modern management of this condition is first presented.

Epidural Neoplasms↗
PubMed2005

Metastasis to nervous system: spinal epidural and intramedullary metastases.

Spinal cord epidural metastasis (SEM) is a common complication of systemic cancer with an increasing incidence. Prostate, breast and lung cancer are the most common offenders. Metastasis usually arises in the posterior aspect of vertebral body with later invasion of epidural space. Pathophysiologically, vascular insufficiency is more important than direct spinal cord compression. The most common complaint is pain, and two thirds of patients with SEM have motor signs at initial diagnosis. Currently magnetic resonance imaging is the most sensitive diagnostic tool. The optimal management of SEM is still arguable, but recent advances in surgical management of SEM and higher complication rate of surgery following radiotherapy should persuade clinicians to consider de novo surgery where possible. Radiotherapy has an important role, particularly in treatment of radiosensitive tumors and in patients who are not candidates for surgery. Novel approaches such as stereotactic radiosurgery are promising; however, response to chemotherapy depends on inherent properties of primary tumor. Recurrent SEM is a substantial problem for which surgery or repeat radiotherapy may be options. Intramedullary metastasis is rare but should be considered in patients with systemic malignancy and asymmetrical presentation of myelopathic symptoms. The prognosis is usually poor and preferred modality of treatment is radiotherapy.

Epidural Neoplasms↗