Abstract
Aim: To know the demographics of the patients most commonly involved by metastatic cord compression in Kashmir and to find the commonest primary organ to metastasize to spine causing cord compression. Methods: A hospital-based 10-year retro-prospective study was carried out in the Department of Neurosurgery of Sher-i-Kashmir Institute of Medical Sciences, Soura from July 2002 to June 2012, which is the premier tertiary care institute of the Kashmir valley. Patients were evaluated for metastatic spinal cord compression based on a standard proforma and specialized investigations were carried out and were deemed necessary by the concerned neurosurgical unit. Results: The commonest primary malignancy to metastasize to the spinal column in our study was Non-Hodgkin’s lymphoma, followed in turn by metastatic squamous cell carcinoma lung, metastatic intraductal carcinoma breast and metastatic adenocarcinoma prostate. Predominantly dorsal spine was the commonest region of spine involved by MSCC. Conclusion: Metastatic spinal cord compression is coming up in a big way. As the long-term cancer survivors increase due to multi-modality treatment protocols aimed at treating cancers and prolonging survival, there will be a proportionate increase in the number of patients who will potentially land up in metastatic spinal cord compression.
Highlights
Spinal cord compression occurs due to displacement of the part or whole of the spinal cord
Of the 46 patients diagnosed with metastatic spinal cord compression, no apparent change in incidence was detected over the decade
Though there was no appreciable difference between their studies and our study as regards to metastases to thoracic spine, our study reported a slightly higher propensity of involvement of cervical spine and a markedly less involvement of lumbar region
Summary
Spinal cord compression occurs due to displacement of the part or whole of the spinal cord. Metastatic spinal cord compression (MSCC) is a well-recognized complication of cancer and is usually an oncological emergency. Three mechanisms are responsible for MSCC, the commonest being haematogenous spread to the vertebral spine causing collapse and compression, accounting for over 85% of cases [2] [4]. MSCC occurs when there is pathological vertebral body collapse or direct tumour growth causing compression of the spinal cord or cauda equina. Malignant spinal cord compression (MSCC) is a common oncological emergency that requires immediate treatment to relieve pain and preserve neurological function [4]. It is a major cause of morbidity in oncology patients [10]. The key investigation for the diagnosis of MSCC is magnetic resonance imaging (MRI) of the whole spine [2] [12]
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