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Matériel pédagogique ZOMETA
Facts about Cancer and Spinal Cord Compression
What is the spinal cord?
The spinal cord is made up of nerves encased in several membranes (1). Between the membranes is a layer of fluid, thus the spinal cord floats within the membranes (1). The cord and its membranes are contained within a bone casing made by the spine (1). This casing is larger than the spinal cord and its coverings, so normally there is plenty of room for the spinal cord to move without injury (1).
Bone in areas with bone metastases
In areas of bone metastases, the bone damage is greater than would be expected from tumor pressure on the bone (1). In fact, tumor cells secrete chemicals that stimulate osteoclasts (1). The osteoclasts wear away portions of bones (reabsorption) leaving holes in the bone, called osteolytic lesions (2). The tumor cells can also secrete chemicals that cause the build up of abnormal bone (2). This is called osteosclerotic bone (2). Both types of abnormal bone can be painful and are weaker than normal bone (2). Because this abnormal area of bone changes the way the entire bone bears weight, the structure of the normal bone surrounding the metastasis is under added stress and can be disrupted (1). This can lead to a pathologic fracture (abnormal break) of the bone.
Symptoms of spinal cord compression in cancer patients
Symptoms of spinal cord compression include back pain, weakness, and loss of sensation (2).
What happens in cancer-related spinal cord compression?
Spinal cord compression is diagnosed in more than 30% of all patients with metastatic disease (2). However, it causes spinal cord dysfunction in only 5% of patients (2). The spinal cord can tolerate pressure for a long time if the onset is slow (2). Spinal cord degeneration may be reversible; there is some leeway if the diagnosis is made early (2). This is important to know, because any of the symptoms of spinal cord compression is a medical emergency (2). Any new or worsening back pain in a patient with cancer should be thoroughly investigated (2).
Treatment of cancer-related spinal cord compression
Treatment of spinal cord compression includes intravenous corticosteroids, radiation, and surgery to relieve the pressure (2). Untreated spinal cord compression can lead to paraplegia (no function in the lower part of the body) (2).
