Kim R Y
Department of Radiation Oncology, University of Alabama, Birmingham 35233.
Ala Med. 1990 Jul-Aug;60(1-2):10-5.
Extradural spinal cord compression (ESCC) as a consequence of metastasis from various primary cancers represents the most common type of malignant lesion affecting the spinal cord. It has been estimated that 5% of all patients with systemic cancer who are autopsied have pathologic evidence of tumor invading the extradural space. The incidence of ESCC is expected to increase due to improved survival of the cancer patient. The current approach to the diagnosis of ESCC depends upon the recognition of early symptoms and signs of spinal cord compression. Despite the increasing clinical awareness of these complications, irreversible loss of ambulation continues to occur in over half of these patients. Early diagnosis is critical since onset of spinal cord injury may be sudden, often progressing to irreversible paralysis in a period of hours. Consequently, physicians dealing with cancer patients must maintain a high index of suspicion. This paper analyzes prognostic factors based on our prospective study and emphasize the use of diagnostic tests in early recognition of ESCC before onset of neurologic deficits.
由各种原发性癌症转移导致的硬膜外脊髓压迫（ESCC）是影响脊髓的最常见恶性病变类型。据估计，在所有接受尸检的全身癌症患者中，有5%有肿瘤侵犯硬膜外间隙的病理证据。由于癌症患者生存率的提高，ESCC的发病率预计会上升。目前ESCC的诊断方法依赖于对脊髓压迫早期症状和体征的识别。尽管临床上对这些并发症的认识有所提高，但仍有超过一半的此类患者出现不可逆转的行走能力丧失。早期诊断至关重要，因为脊髓损伤可能突然发生，常在数小时内进展为不可逆性瘫痪。因此，治疗癌症患者的医生必须保持高度的怀疑指数。本文基于我们的前瞻性研究分析了预后因素，并强调在神经功能缺损出现之前早期识别ESCC时使用诊断测试。
