1. Spinal Cord Compression By: Sharon Sanders, Stacy Webb, Tonya Miller, Adrianne Rice & Lynn Davenport

3. More Commonly Seen In Breast Lung Kidney Prostate Myeloma Lymphoma

5. Tables for: Spinal Cord Compression: An Obstructive Oncologic Emergency [Topics in Advanced Practice Nursing eJournal 2(4), 2002. © 2002 Medscape] Table 1. Symptoms of Spinal Cord Compression, by Tumor Location LocationSigns and Symptoms Cervical spineHeadache or neck, shoulder, or arm pain Breathing difficulties Loss of sensation in the arms Muscle weakness in the neck, trunk, arms, and hands Paralysis involving the neck, trunk, arms, and hands Thoracic spinePain in the chest and/or back Loss of sensation below the level of the tumor Increased sensation above the level of the tumor Muscle weakness Paralysis Positive Babinski reflex Bladder and bowel problems Sexual dysfunction Lumbosacral spineLow back pain that may radiate down the legs and/or perineal area Weakness in the legs and feet Paralysis in the legs and feet Loss of sensation in the legs and feet Bladder and bowel problems Sexual dysfunction Foot drop Decreased or absent reflexes in the legs

6. Priority Assessments Inflammation Edema Venous Stasis Impaired Blood Supply to Nervous Tissues Pain

7. Diagnostic Assessment Percussion Tenderness at the Level of Compression Abnormal Reflexes Sensory and Motor Abnormalities MRI Myelogram Spinal Cord X-Rays Bone Scans CT Scans Spinal Tap Needle Biopsy

8. Treatment Goal Pain Control Reduce/Prevent nerve damage Avoid Complications High Dose Corticosteroids Radiation Therapy Biphosphates ( to reduce pathological fractures and bone pain)

9. Nursing Diagnosis Disturbed Sensory Perception Acute /Chronic Pain Impaired Physical Mobility Ineffective Individual Coping

10. Nursing Interventions Ongoing assessment of neurological function Pain Medications as Ordered Prevent Complications of Immobility Provide Encouragement and Support to Patient & Family

11. Outcome Depends on the Severity and Rapidity of Onset Poor Neurological Function Before Treatment/Less Likely to Regain Complete Function Complete Paralysis/Usually don’t Regain complete Neurological Function