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Analysis of the Relationship Between the Epidural Spinal Cord Compression (ESCC) Scale and Paralysis Caused by Metastatic Spine Tumors
| Content Provider | Scilit |
|---|---|
| Author | Uei, Hiroshi Tokuhashi, Yasuaki Maseda, Masafumi |
| Copyright Year | 2018 |
| Description | Journal: Spine A retrospective, single-institute, and radiographic study.To evaluate the relationship between the epidural spinal cord compression (ESCC) scale and the severity of metastatic spine tumor-induced paralysis.The ESCC scale is used to evaluate the grade of spinal cord compression on T2-weighted magnetic resonance imaging (MRI). However, few studies have investigated the relationship between such MRI findings and paralysis.The subjects were 467 patients with metastatic spine tumors and grade 1b or worse spinal cord compression according to the ESCC scale. Evaluations using this scale were performed by 3 spine surgeons, and results that were obtained by 2 or more surgeons were adopted. We also examined patients whose spinal cord compression deteriorated by one grade or more to ASIA grade C or worse within the first 3 weeks after MRI.The kappa coefficients for inter- and intra-examiner variability were 0.90 and 0.95, respectively. ASIA grade D or worse paralysis developed in ≥50% of the patients with ESCC grade 1b or worse spinal cord compression at the C1-T2 and ≥50% of those with ESCC grade 1c or worse spinal cord compression at the T3-L5. The frequency of ASIA grade C or worse paralysis was high among the patients with ESCC grade 2 or worse spinal cord compression at the C7-L1. Nineteen patients experienced rapid deterioration of one grade or more to ASIA grade C or worse paralysis within the first 3 weeks after MRI. Of these, paralysis occurred in ≥30% of the patients with anterolateral or circumferential cord compression combined with ESCC grade 2 or 3 compression at the C7-L1.The severity of paralysis was not correlated with the ESCC scale. Patients with anterolateral or circumferential ESCC grade 2 or 3 cord compression at the C7-L1 are at high risk of rapidly progressive paralysis.4This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895138/pdf https://insights.ovid.com/Common/SSRPdf/V1/JOURNAL/spne/04.02/00007632-900000000-95402/root/v/2017-11-26T182729Z/r/application-pdf |
| Ending Page | E455 |
| Page Count | 8 |
| Starting Page | E448 |
| ISSN | 03622436 |
| e-ISSN | 15281159 |
| DOI | 10.1097/brs.0000000000002378 |
| Journal | Spine |
| Issue Number | 8 |
| Volume Number | 43 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2018-04-15 |
| Access Restriction | Open |
| Subject Keyword | Epidural Spinal Cord Compression Scale Magnetic Resonance Imaging Metastatic Spinal Tumors |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Neurology (clinical) Sports Science |
