Spinal Cord Compression: An Obstructive Oncologic Emergency

Maryjo Osowski, RN, MSN, AOCN


Topics in Advanced Practice Nursing eJournal. 2002;2(4) 

In This Article

Diagnostic Tests

Laboratory tests include a complete blood cell count with differential, an erythrocyte sedimentation rate determination, urinalysis, and a chemistry profile including calcium and liver function studies. The complete blood cell count and erythrocyte sedimentation rate may be useful in differentiating SCC from infection, whereas the chemistry profile may indicate the primary cancer or the patient's general condition.[10]

Imaging studies include plain radiography and magnetic resonance imaging (MRI) with contrast of the spine. Plain films of the spine frequently demonstrate associated vertebral blastic or lytic lesions.[12] However, gadolinium-enhanced MRI provides the best definition of spinal lesions. Magnetic resonance imaging not only shows cord compression caused by extra dural masses but also shows paravertebral masses, intramedullary disease, and bone metastasis. Magnetic resonance imaging of the entire spine should be ordered, because approximately 10% to 30% of patients with clinical symptoms of SCC have multiple lesions.[4] Lumbar puncture is contraindicated because removal of cerebrospinal fluid may worsen the SCC.[3]