Sun Hai, Nemecek Andrew N
Department of Neurological Surgery, CH8N, Oregon Health and Science University, 3303 SW Bond Avenue, Portland, OR 97239, USA.
Emerg Med Clin North Am. 2009 May;27(2):195-208. doi: 10.1016/j.emc.2009.02.001.
Malignant epidural spinal cord compression (MESCC) is a common neurologic complication of cancer. MESCC is a medical emergency that needs rapid diagnosis and treatment to prevent paraplegia. Patients with malignancy who present with new onset of neurologic signs and symptoms should undergo emergent evaluation including magnetic resonance imaging of the entire spine. If MESCC is diagnosed, corticosteroids should be administered. Simultaneously, spine surgery and oncology teams should be immediately consulted. If indicated, patients should undergo maximal tumor resection and stabilization, followed by postoperative radiotherapy. Emerging treatment options such as stereotactic radiosurgery and vertebroplasty may be able to provide some symptomatic relief for patients who are not surgical candidates.
恶性硬膜外脊髓压迫症（MESCC）是癌症常见的神经系统并发症。MESCC是一种医疗急症，需要快速诊断和治疗以预防截瘫。出现新发神经体征和症状的恶性肿瘤患者应接受紧急评估，包括全脊柱磁共振成像。如果诊断为MESCC，应给予皮质类固醇。同时，应立即咨询脊柱外科和肿瘤学团队。如果有指征，患者应进行最大程度的肿瘤切除和脊柱固定，随后进行术后放疗。立体定向放射外科和椎体成形术等新兴治疗选择可能能够为不适合手术的患者提供一些症状缓解。
