MALIGNANT SPINAL CORD COMPRESSION, EARLY CLINICAL OUTCOME

Introduction: Metastatic spinal cord compression (MSCC) is usually an oncological emergency and a well-recognized complication of cancer. Lung, prostate, multiple myeloma, non-Hodgkin lymphoma, and breast are the most common underlying tumors. These five types of malignancy, in addition to sarcomas and renal cancers account for about 70% of cases of metastatic epidural spinal cord compression. If untreated, metastatic epidural compression progresses, causing paralysis, sensory loss, and sphincter incontinence. Material and Methods: Prospective descriptive cross sectional study to assess prognostic factors and clinical outcome of malignant spinal compression among patients attending Suez Canal university hospital in period from 2016 to 2017. Results: A total of 48 patients were included in this study. Males accounting 45.8% and 54.2% were females. Breast cancer was the most incident (27%) to cause spinal cord compression. Dorsal vertebra was the most common site affected (45, 8%). Most of the studied patients (79.2%) presented with MSCC within less than 12 months from tumor diagnosis. 70.8% of studied population were managed by radiotherapy, 12.5% managed by surgery and 16.7% managed by both. The mean overall survival among the studied patients was 6.5 months. Conclusions: In Egypt, no documented data of incidence of MSCC. Most of MSCC cases (79%) were presented within less than 12 months from time of primary tumor diagnosis and that was significantly related to better post management functional outcome. After management of MSCC cases 50% showed improvement of motor function, no interval changes in (41.7%) and (8.3%) showed deterioration of motor function. After 6 months of follow up of MSCC 37.5% of cases have residual and 12.5% have recurrence or progression of disease.