What do we know about safety netting patients at risk of metastatic spinal cord compression? A scoping review

Metastatic spinal cord compression is a potentially devastating consequence of cancer. This oncological emergency requires early recognition and treatment to prevent irreversible spinal cord injury and paralysis. Provision of information to at risk patients has been recommended in the 2023 NICE Guidelines. However, it is unclear when, how and what information should be provided.

To investigate how healthcare professionals provide safety netting information to patients at risk of metastatic spinal cord compression.

This scoping review utilised the Arksey and O'Malley Framework and the recommendations by the Joanna Briggs Institute. Relevant literature was identified following a systematic search of three databases, with grey literature accessed through a targeted search of relevant websites. Following data charting, thematic analysis was used to identify salient themes across the dataset.

A total of N = 197 records were identified. Following removal of duplicates, title and abstract screening, N = 24 records were screened and N = 9 were included for full analysis. Three key themes were identified: information format and dissemination, health education and raising awareness, and timeliness of safety netting.

All patients with or at risk of developing bony metastases should be provided with safety netting information about metastatic spinal cord compression. Generalist clinicians should be prepared to share this information to empower patients to present early with symptoms. Further research is needed to explore the information needs and perspectives of patients with or at risk of metastatic spinal cord compression.