Treatment outcome and complications in patients treated for malignant epidural spinal cord compression (SCC)

Sixty-seven episodes of spinal cord compression (SCC) were retrospectively evaluated regarding presenting features and treatment outcome. They were divided into three motor function groups. Group 1 consisted of 35 ambulatory patients, group 2 of 29 non-ambulatory patients and group 3 of three parapl...

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Bibliographic Details
Published in:Journal of neuro-oncology 1985-01, Vol.3 (1), p.77-84
Main Authors: Martenson, Jr, J A, Evans, R G, Lie, M R, Ilstrup, D M, Dinapoli, R P, Ebersold, M J, Earle, J D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cauda Equina - radiation effects
Combined Modality Therapy
Emergencies
Epidural Space
Female
Humans
Laminectomy
Male
Middle Aged
Nerve Compression Syndromes - radiotherapy
Prognosis
Radiotherapy Dosage
Spinal Cord Compression - radiotherapy
Spinal Cord Neoplasms - radiotherapy
Spinal Cord Neoplasms - secondary
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Summary:Sixty-seven episodes of spinal cord compression (SCC) were retrospectively evaluated regarding presenting features and treatment outcome. They were divided into three motor function groups. Group 1 consisted of 35 ambulatory patients, group 2 of 29 non-ambulatory patients and group 3 of three paraplegic patients. Lower extremity weakness was usually a late presenting feature and was frequently rapidly progressive. We suggest that SCC is an emergency, as successful treatment is unlikely if motor function is poor. All of the group 1 patients completing treatment remained ambulatory, in contrast to group 2 patients, in which only 25% regained the ability to walk, and group 3 patients, none of whom regained the ability to walk. Initial surgery or initial radiotherapy appeared to be equally effective in restoring or maintaining the ability to walk. Survival of patients ambulatory at completion of treatment was superior to that of non-ambulatory patients (p less than 0.03). Analysis of steroid-related complications suggested that frequent, severe and sometimes fatal complications can result from prolonged use with these drugs.
ISSN:0167-594X
1573-7373
DOI:10.1007/BF00165175