Malignant spinal cord compression: a prospective evaluation

To determine the influence of treatment on ambulancy, pain control and functional outcome of patients with Malignant Spinal Cord Compression.

One hundred and thirty-seven patients with Malignant Spinal Cord Compression presenting or referred to the Department of Radiation Oncology, Westmead Hospital between August 1, 1989 and August 1, 1990 were studied prospectively. Patients were treated with palliative radiation therapy alone, surgery followed by radiotherapy or surgery alone. Two patients were not treated. Post-treatment outcome was assessed in terms of ambulatory status, improvement in pain and functional independence using the Functional Independence Measure.

Thirteen of 16 patients (81%) who were ambulant pre-treatment remained ambulant after treatment. Two of 16 patients (16.5%) who were non-ambulant pre-treatment became ambulant following treatment. Pain improved following treatment in 22 of 30 patients (73%). This benefit was seen equally for ambulant and non-ambulant patients. A high level of functional independence was maintained in patients who remained ambulant.

We conclude that prompt treatment of patients with Malignant Spinal Cord Compression while still able to walk is effective in maintaining ambulancy and functional independence, and that treatment improves pain in most patients.