Neoplastic disease that involves the spine with spinal cord compression may be devastating.
Primary spinal cord tumors arise from the different elements of the CNS, including neurons, supporting glial cells, and meninges. Anatomically, neoplasms of the spinal cord may be classified according to the compartment of origin, either intramedullary (inside the cord) or extramedullary (outside the cord). Additionally, cancers that metastasize to the vertebrae or surrounding tissues frequently cause spinal cord compression.
Metastatic lesions are featured in this discussion since they cause 85% of the cases of neoplastic spinal cord compression. The clinical presentation tends to be indistinguishable from that of primary cancers of the spine.
For the emergency physician, the cell origin of the tumor is less of a concern than the consequent syndromes of spinal cord dysfunction.