The following is a summary of “Neurosurgical emergencies in spinal tumors: pathophysiology and clinical management,” published in the February 2024 issue of Oncology by Faraj al.
Spinal tumors, whether metastatic or primary, pose significant challenges due to their location and potential complications. These tumors can be extradural, intradural extramedullary, or intramedullary, with extradural metastases being the most common. Among the complications, spinal cord compression (SCC) is particularly devastating, often presenting with progressive paralysis, paresthesia, or autonomic dysfunction, necessitating urgent intervention. Clinical suspicion of SCC is crucial, especially in patients with a history of cancer presenting with back or neck pain. Magnetic resonance imaging (MRI) is the preferred imaging modality for diagnosis. Management of SCC typically involves a multidisciplinary approach, aiming for symptom control and prevention of irreversible functional loss.
Surgical decompression and reconstruction followed by radiotherapy have shown better outcomes compared to radiotherapy alone. Modern surgical techniques, including minimally invasive spinal surgery (MISS) and vertebral augmentation, have advanced the field, offering improved palliation and functional outcomes. Apart from SCC, cancer patients may also face other spinal complications such as spine infections, including surgical site infection (SSI), spinal epidural abscesses (SEA), and vertebral osteomyelitis, often necessitating prompt diagnosis and treatment.
This review provides insights into the clinical presentation, pathophysiology, and management strategies for major spinal oncologic emergencies, encompassing both surgical and nonsurgical approaches.
Source: emergcancercare.biomedcentral.com/articles/10.1186/s44201-024-00024-5
