NICE Guidance - Metastatic spinal cord compression

NICE Pathway:  Metastatic spinal cord compression: Diagnosis and management of adults at risk

Metastatic spinal cord compression (MSCC) is defined in this pathway as spinal cord or cauda equina compression by direct pressure and/or induction of vertebral collapse or instability by metastatic spread or direct extension of malignancy that threatens or causes neurological disability.

It is important to recognise the impact of an MSCC diagnosis on people with MSCC and their families and carers, and understand their needs and the support required throughout their care.

Some people with MSCC experience delays in their treatment and care and may, as a result, develop avoidable disability and die prematurely.

This pathway will help to ensure that facilities are available for early diagnosis and that treatment is coordinated, follows best practice and whenever possible prevents paralysis from adversely affecting the quality of life of people living with cancer.

In 2011, the Department of Health published a Manual for cancer services: acute oncology – including metastatic spinal cord compression measures.

NICE Guideline (CG75): Metastatic spinal cord compression: Diagnosis and management of adults at risk of and with metastatic spinal cord compression

The advice in the NICE guideline covers:

  • adults who have, or are at risk of developing, metastatic spinal cord compression because they have cancer elsewhere in their body that has spread to their spine

It does not specifically look at:

  • children, or adults whose cancer started in the spine or who have compression of the spinal cord that is not caused by cancer