Spinal cord compression surgery
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Surgery is the mainstay of treatment in localised compression. Emergency radiation therapy (usually 20 Gray in 5 fractions) is the mainstay of treatment for malignant spinal cord compression. It is very effective as pain control and local disease control. Some tumors are highly sensitive to chemotherapy (e.g. lymphomas, small cell lung cancer) and may be treated with chemotherapy alone.
Surgery
All the patients with acute spinal cord compression must be admitted. The mainstay of treatment includes surgery for most of the cases except for compression caused by metastasis. The treatment in such cases is mostly palliative. Antibiotics are indicated in cases of compression caused by an epidural abscess.[1][2]
| Cause of compression | Prefered treatment | Adjuvant therapy* |
|---|---|---|
| Trauma | Decompressive/stabilization surgery of vertebral column | + |
| Disc herniation | Laminectomy | + |
| Metastasis | Corticosteroids + radiation therapy | + |
| Epidural abscess | CT guided aspiration of abscess + Antibiotics | + |
| Adjuvant therapy includes : Maintenance of fluid volume, nutritional status , prevention of stress ulcers , in cases of compression caused by abscess antibiotics are indicated. | ||
References
- ↑ Tsuzuki S, Park SH, Eber MR, Peters CM, Shiozawa Y (2016). “Skeletal complications in cancer patients with bone metastases”. Int. J. Urol. 23 (10): 825–832. doi:10.1111/iju.13170. PMID 27488133.
- ↑ Ropper, Alexander E.; Longo, Dan L.; Ropper, Allan H. (2017). “Acute Spinal Cord Compression”. New England Journal of Medicine. 376 (14): 1358–1369. doi:10.1056/NEJMra1516539. ISSN 0028-4793.
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