Spinal cord compression: the hospice perspective

Spinal cord compression is an important complication of metastatic, malignant disease. It has not been extensively studied in the hospice setting. We conducted a retrospective study of the records of 34 patients with a history of cord compression. Clinical presentation, investigations, treatment, and functional outcome were recorded. Outcome was related to performance status before the development of spinal cord compression, and to motor function at the time of treatment. Patients with low scores were less likely than those with high scores to benefit from attempts to reverse the cord compression. These assessments may help the clinician decide which patients to refer for investigation and treatment. Overall median survival was found to be three months for those who were ambulatory after treatment, but only three weeks for those who were not. Patients who were not ambulatory following therapy suffered a wide range of related problems and required intensive palliative care.