Published 27 November 2008, doi:10.1136/bmj.a2538
Cite this as: BMJ 2008;337:a2538

Practice

Guidelines

Diagnosis and management of patients at risk of or with metastatic spinal cord compression: summary of NICE guidance

¹ Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Nottingham NG7 2UH, ² Royal Orthopaedic Hospital NHS Foundation Trust, Department of Spinal Surgery, Northfield, Birmingham B31 2AP, ³ Govan Health Centre, Glasgow G51 4BJ, ⁴ National Collaborating Centre for Cancer, Cardiff CF10 3AF

The first 150 words of the full text of this article appear below.

Metastatic spinal cord compression is thought to affect more than 4000 people each year in the United Kingdom.^{1 2} Treatment before paralysis is clinically effective and cost effective. Despite the fact that spinal pain is often present for three months and neurological symptoms for two months before paraplegia, almost 50% of patients are unable to walk by the time of diagnosis.^{1 3}

Recognition is difficult as non-specific back pain is common in both the general population and patients with cancer.^{4 5} In addition, 23% of patients with spinal metastases have no prior cancer diagnosis.¹ The added distress and disability caused by paralysis affecting someone already living with cancer cannot be overestimated.⁶

This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on how to diagnose and manage patients at risk of or with metastatic spinal cord compression.⁷ The algorithm outlines the management of patients with suspected . . . [Full text of this article]

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