One of the many siginificant complications of cancers we encounter in the ED is cord compression. Here are pearls from a recently published systematic review focused on metastasis-associated spinal cord compression:

• Spinal cord metastatic lesions affect 5% to 10% of the oncology patients in the United States
• Thoracic spine is most commonly involved (70%), followed by lumbosacral spine, then cervical spine 
• Primary sources of spinal metastases are the lung (31%), breast (24%), gastrointestinal tract (9%), prostate (8%), melanoma (4%), kidney (1%), lymphoma (6%), and unknown origin (2%)
• Patients present with pain, motor/sensory deficits, and/or even autonomic dysfunction and neurogenic shock

References

Vavourakis M, Sakellariou E, Galanis A, Karampinas P, Zachariou D, Tsalimas G, Marougklianis V, Argyropoulou E, Rozis M, Kaspiris A, Pneumatikos SG. Comprehensive Insights into Metastasis-Associated Spinal Cord Compression: Pathophysiology, Diagnosis, Treatment, and Prognosis: A State-of-the-Art Systematic Review. J Clin Med. 2024 Jun 19;13(12):3590. doi: 10.3390/jcm13123590. PMID: 38930119; PMCID: PMC11205147.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11205147/