ABSTRACT
Presence of bone metastases is a sign of disseminated disease; and a commonly seen oncologic emergency related to bone metastases is malignant spinal cord compression, which is defined as radiographic compression of spinal cord or cauda equina. Sagittal T2 supplemented with axial T1 or T2 weighted scans shows the degree of spinal cord compression and the soft tissue component of the mass. Axial T2-weighted images are used to assign the 6-point epidural spinal cord compression score which can be used to quantify the extent of spinal cord or thecal cord compression, and define management. The extent of epidural extension in combination with tumor radiosensitivity allows clinicians to determine optimal radiotherapy treatment plan and the need for surgical decompression. The decision to purse surgery is dependent on many factors including spinal stability, degree of cord compression, neurologic deficits, radiosensitivity, patient preferences, and patient prognosis.
