Management of Metastatic Spinal Cord Compression in Ireland: Are Surgeons Overlooked?

Abstract

Background: The National Institute of Health and Clinical Excellence (NICE) provide a framework of evidencebased guidelines for the management of metastatic spinal cord compression (MSCC). We aimed to compare our center's provision of service to these best practice guidelines and discuss key shortcomings with their implications for the spinal surgeon. Methods: Patients with radiologic evidence of MSCC over a 30-month period were identified using the hospital electronic radiological database. A chart review was performed analyzing MSCC management. Results: Forty-one patients were identified. Pain was the most common presenting complaint, occurring in 76% of patients. Radiotherapy alone was the most common therapy employed (93% of patients). A surgical opinion was sought for 51% of patients. Histological diagnosis of the causative lesion occurred in 5 patients from surgical specimens. Conclusions: Incongruities between NICE guidelines and our practice exist. Early involvement of the spinal surgical services needs to be encouraged. Establishing a histological diagnosis of the spinal lesion should be seen as of therapeutic importance.

Effect of Educational Program for Nurses on Clinical Outcomes of Cancer patients with Metastatic Spinal Cord Compression

“…Regarding patient diagnosis, the current study revealed that the most common patient diagnosis was breast(60%)followed by prostatic (23.3%),(10%) had Multiple myeloma and 6.66 % had other types of cancer, which is supported by Nakata E and et al 2020 (80 ) (81) , who reported that (26.8%) of studied patients had prostatic and lung cancer and only (14.6%) had breast cancer. This study and its results also against with to what was reported byShah S and et al 2021 (82) who reported that lung (37.9%), breast (17.2%), and renal (10.3%).This difference as a result of increased the females sample in the study.…”

The Management of Metastatic Spinal Cord Compression in Routine Clinical Practice

“…Since multidisciplinary collaboration is paramount for the successful treatment of MSCC, the fact that only 34% of hospitals had a Board for MSCC and only 37% had set up a multidisciplinary protocol for patients with MSCC is a grave cause for concern. These results are in line with those from other countries [12][13][14]19] and suggest that there is room for improvement in the management of SCC in routine practice.…”

“…However, whether these methods are actually used in routine clinical practice is largely unknown. In fact, audits have reported inconsistencies between recommendations of clinical guidelines issued by the National Institute for Health and Care Excellence (NICE) and actual routine practice in the United Kingdom and Ireland [12][13][14].…”