NICE guidance

• NICE guidance - Early detection:

  • Contact the Urgent Care Team (within 24 hours) to discuss the care of patients with cancer and any of the following symptoms suggestive of spinal metastases:
  • pain in the middle (thoracic) or upper (cervical) spine
  • progressive lower (lumbar) spinal pain
  • severe unremitting lower spinal pain
  • spinal pain aggravated by straining (for example, at stool, or when coughing or sneezing)
  • localised spinal tenderness
  • nocturnal spinal pain preventing sleep
• NICE Guidance - Contact Urgent care:

  • If a Patient with cancer and symptoms suggestive of spinal metastases who have any of the following neurological symptoms or signs suggestive of MSCC, and view them as an oncological emergency:
  • Neurological symptoms including radicular pain, any limb weakness, difficulty in walking, sensory loss or bladder or bowel dysfunction
  • Neurological signs of spinal cord or cauda equine syndrome
  • Imaging: whole spine MRI