Spinal neurologic complications of systemic solid neoplasms

Spinal cord dysfunctions represent a major cause of morbidity and suffering in cancer. There are four main manifestations of metastatic epidural spinal cord compression: pain, motor loss, sensory loss, and autonomic dysfunction. Any of these can be disabling potentially impairing, suddendly and drastically, the quality of life. Epidural spinal cord metastatic compression is the most frequent complication, affecting almost 5-10% of cancer patients. Understanding of early symptoms, clinical course and treatment could contribute to prevent or minimize neurologic deficit development. Early diagnosis is crucial because the most important prognostic factor for functional outcome is neurological function and current treatments usually stop the course of the disease but much less commonly restore lost neurological functions. In this paper we will review the more frequent causes of neoplastic spinal cord dysfunctions, paying attention in particular to early clinical signs and symptoms, to the more adequate neuroradiological investigations and to the more effective treatment options. Furthermore we will underline some aspects and causes of the diagnostic delay and review adjuvant therapies that will ameliorate quality of life of these patients. © Mattioli 1885 Casa Editrice.