Rapid, Cost-Effective Diagnosis of Spinal Cord Compression Due to Cancer

Spinal cord compression in patients with cancer is a devastating complication that can be prevented by effective early detection of epidural metastases. Older algorithms for the diagnosis of epidural metastases call for plain spine films and bone scans, followed by magnetic resonance imaging (MRI) in appropriate patients. Data from the only prospective study of back pain in cancer patients demonstrate that immediate MRI of the symptomatic area provides a more rapid diagnosis, is less expensive, and obviates the need for a time-consuming series of studies. A "screening" total-spine MRI using a shortened but comprehensive protocol would lead to further reductions in cost.