Epidural spinal cord compression

Silvia Spinazzé, Augusto Caraceni, Dirk Schrijvers

Research output: Contribution to journalArticlepeer-review


Spinal cord compression from epidural metastases (epidural spinal cord compression, ESCC) is the most common neurological complication of cancer after brain metastases. Extradural compression represents 97% of spinal cord metastatic lesions. ESCC usually occurs in patients with disseminated disease. The most common tumours associated with ESCC are lung and breast cancers, followed by lymphoma, myeloma, prostate cancer and sarcoma. ESCC represents a medical emergency because delayed treatment can be responsible for irreversible deficits, such as paralysis and loss of sphincter control. Patients with ESCC require a multidisciplinary diagnostic and therapeutic approach. Clinical suspect is radiologically detected for confirmation. The median expected survival time from diagnosis usually ranges from 3 to 6 months. The nature of the primary tumour and the degree of the neurological deficit are the most important factors affecting survival. The lack of prospective randomized trials makes the optimal treatment of ESCC controversial and the decision is to be tailored to the individual. Treatment options include: bed rest, administration of corticosteroids, surgery followed by radiation therapy, radiotherapy alone and, to a limited extent, chemotherapy and hormonal therapy.

Original languageEnglish
Pages (from-to)397-406
Number of pages10
JournalCritical Reviews in Oncology/Hematology
Issue number3
Publication statusPublished - Dec 2005


  • Metastasis
  • Neoplasm
  • Spinal cord compression

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology


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