CLINICAL OUTCOME IN METASTATIC SPINAL-CORD COMPRESSION - A PROSPECTIVE-STUDY OF 153 PATIENTS

Background - Despite many reports on metastatic spinal cord compressio n, only very few prospective studies of the clinical outcome of spinal cord compression have been carried out. Methods - 153 consecutive pat ients with a known malignant solid tumor and a myelographically verifi ed diagnosis of spinal cord compression were followed with regular neu rological examination. Results - At time of diagnosis 79 patients were walking, while the remaining were bedridden. In total 21 of the 74 in itially non-walking patients began walking after therapy. There was a need for urinary catheter in 57 (37%) patients at the time of diagnosi s. During follow-up, 10 of 57 patients (18%) dispensed with the cathet er. A total of 116 patients experienced radicular pain at the time of diagnosis, while in 95 of 116 patients (83%) the pain disappeared afte r therapy. Conclusion - the present study confirms, that early diagnos is, i.e., while the patients are still ambulatory is most important, b ut the prognosis for recovery of ambulatory function is not as pessimi stic as earlier described. In addition the results indicate that suppl ementary systemic therapy, when available, may have a positive influen ce on recovery.