Spinal cord compression (non-traumatic)

Background

• Most often from cancer

Diagnosis

• MRI is study of choice
  • If unavailable consider CT myelography

Treatment

1. Consult neurosurgery and/or rad onc
2. Corticosteroid therapy
   1. No longer indicated.
   2. Consider emergent radiation, surgical intervention, and/or chemo therapy

Steroids in Cord Compression

Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death.

—Pharmacological therapy for acute spinal cord injury.

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Disposition

• Admit

See Also

• Spinal Cord Trauma
• Spinal Column Injuries (Cervical)
• Neurogenic Shock