Ruckdeschel John C
Wayne State University, School of Medicine, USA.
Oncology (Williston Park). 2005 Jan;19(1):81-6; discussion 86, 89-92.
Several key areas must be considered in the diagnosis and management of spinal cord compression. Because the outcome can be devastating, a diagnosis must be made early and treatment initiated promptly. Although any malignancy can metastasize to the spine, clinicians should be aware that this occurs more commonly in certain diseases, i.e., lung cancer, breast cancer, prostate cancer, and myeloma. The current algorithm for early diagnosis of spinal cord compression involves neurologic assessment and magnetic resonance imaging of the entire spine. Treatment generally consists of intravenous dexamethasone followed by oral dosing. Depending on the extent of the metastases, symptoms may also be managed with nonnarcotic pain medicines, anti-inflammatory medications, and/or bisphosphonates, with local radiation administered as needed. Surgery has often led to destabilization of the spine.
在脊髓压迫症的诊断和管理中，必须考虑几个关键领域。由于后果可能是毁灭性的，所以必须尽早做出诊断并立即开始治疗。虽然任何恶性肿瘤都可能转移至脊柱，但临床医生应意识到，这种情况在某些疾病中更常见，即肺癌、乳腺癌、前列腺癌和骨髓瘤。目前脊髓压迫症的早期诊断算法包括神经学评估和全脊柱磁共振成像。治疗通常先静脉注射地塞米松，然后口服给药。根据转移的程度，症状也可用非麻醉性止痛药、抗炎药和/或双膦酸盐进行处理，并根据需要进行局部放疗。手术常常会导致脊柱失稳。
