ABSTRACT
Spinal cord compression is seen in about 5% of cancer patients overall, with an incidence of about 15% in myeloma sufferers and around 10% in patients with prostate cancer. The spinal column is the commonest site for bone secondary deposits. At autopsy, 70% of cancer patients will have a vertebral column deposit. There is ascending loss of sensation with numbness which usually stops about one vertebral body below the level of the cord compression. Radiation treatment can be used if there is no spinal instability and the tumour is known to be radiosensitive. Plain X-ray of the spine detects about 85% of spinal lesions, but a negative result does not exclude metastases. Paraplegia due to malignant spinal cord compression is always irreversible and therefore is not an emergency as such.
