Acute transverse spinal cord syndrom due to spinal metastasis - Etiology and developement of treatment recommendations

Pathologic vertebral fractures are more common in patients with MESCC than previously described. However, they do not predict severe paralysis on their own. In contrast, complete spinal cord compression (ESCC grade 3) was found to be a significant predictor of severe impairments. Further prognostic factors identified were patient age, duration of paralysis, and SINS values. These should be implemented in future follow-up algorithms, to help patients avoid neurological complications. The postoperative results demonstrated in this study show that surgical concepts relying on stabilization and decompression are capable to reverse paralysis already in the acute recovery stage. Due to the complex decision-making, cases should always be discussed by tumor boards.