nightflight1945 wrote:
It is D , for cord compression syndrome after MRI and high dose dexa administration , if the etiology is metastatic cancer go for Radiotherapy and if it is due to hematoma go for surgical decompression.
No doubt if there is no S/S of cord compression radiotherapy (provided primary tumor is radiosensitive) is the therapy of choice .But ,if cord compression is there then surgical intervention takes priority :
Metastatic vertebral tumors not associated with pathologic fracture causing cord compression by bone fragments may be treated with x-ray therapy, which is to be administered on an emergency basis in the presence of epidural intraspinal tumor mass if there is beginning loss of function and a pathologic diagnosis has previously been made. The indications for operation to treat metastatic spine tumors are as follows: (1) rapid progressive loss of function; (2) presence of a known radioresistant tumor; (3) undiagnosed mass, especially with the possibility of another diagnosis, such as abscess or hematoma; (4) recurrence or progression of symptomatic tumor growth after radiation therapy; and (5) presence of progression of symptomatic spinal deformity due to vertebral instability. Radiation therapy may be used in conjunction with operative decompression and stabilization to retard or prevent recurrence. Radiation therapy alone should be used to relieve pain when spinal cord function is intact and there is no evidence of bony compression
Ref: Current surgical diagnosis and treatment
The patient has
- Just 10 days history of spinal cord symptoms (rapid progression)
- S/S of cord compression are there
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