Acute Medicine | Palliative care | Recognising and managing malignant spinal cord compression

Recognising and managing malignant spinal cord compression
Session overview
Description
Some end of life care situations are considered emergencies which require urgent intervention. One of these is spinal cord compression. This session provides a framework for recognising and managing spinal cord compression, when immediate treatment may restore function that would otherwise be lost.

This session was reviewed by Richard Kitchen and last updated in January 2021.

Additional material added June 2022 by Rachel Lee, Senior Specialist Nurse.

Learning objectives
By the end of this session you will be able to:

• outline the underlying pathophysiology of spinal cord compression secondary to cancer in an end of life care population
• describe the signs and symptoms associated with spinal cord compression
• explain the immediate management of spinal cord compression
• outline the longer-term management of end of life care patients with spinal cord compression

Suspected spinal cord compression (SCC) is one of the few situations in end of life care that is considered a medical emergency. This is because immediate diagnosis and treatment can preserve or restore physical function, even if some neurological damage has been done.

There are several possible causes of spinal cord compression but in our patient population, the most common reason is cancer.

This session concentrates on spinal cord compression secondary to cancer, discussing the frequency and explaining the pathophysiology that underlies it. It will also explain how to recognise the signs and symptoms of spinal cord compression and provide a framework for immediate management. Finally, it will outline the longer-term management and support of patients with spinal cord compression, which involves a multi-professional approach.