Spinal Metastasis
Epidemiology
80% cancer patients have spinal metastasis at autopsy
Spine is number one site for bony metastasis (50%)
Cause
Hexagon: PBBLTK
Prostate Breast
80% cancer patients have spinal metastasis at autopsy
Spine is number one site for bony metastasis (50%)
Hexagon: PBBLTK
Prostate Breast
Clinical diagnosis
- based on a sclerotomal distribution of motor &/or sensory symptoms or signs
Caused by impingement of exiting nerve roots
- HNP
- zygo-apophyseal / facet joint hypertrophy
- neuro-central joint hypertrophy
May be acute or chronic
M>F
Peak age 50-54
C7 > C6
Spinal cord dysfunction
- extrinsic compression of the cord or its vascular supply
- caused by degenerative disease of spine
Most common spinal cord dysfunction in patients > 55 years old
C5/6 commonest level
Neck involved in 86%
- second most common site after hands and feet
- closely associated with MCPJ subluxation
Males / Steroid use / Seropositivity Nodules / Severe long standing disease
Atlanto-axial subluxation
Subaxial subluxation
Superior migration ondontoid