Presenting symptoms of neoplastic spinal cord compression

The cases of 28 patients with neoplastic spinal cord compression were reviewed. The most common presenting symptoms were: back pain (68%), bilateral leg weakness (61%), urinary retention (36%), and bilateral leg numbness (32%). Twelve patients (43%) had known neoplastic disease prior to diagnosis of spinal cord compression. Only two patients (7%) were diagnosed within one week of the onset of major spinal symptoms. The commonest symptoms associated with delay in diagnosis were again back pain (50%) and bilateral leg weakness (38%). However, when certain symptoms were present, diagnosis was almost always delayed, particularly with unilateral leg weakness or pain (100%), ataxic gait (80%), and back pain (68%). Symptoms in the neck, chest, and arms were also always associated with delayed diagnosis.