Metastatic spinal cord compression (MSCC)

Reviewed January 2025

Cancer cells sometimes grow around the spinal cord and cause compression on the spinal cord which results in neurological damage. Metastatic spinal cord compression (MSCC) can result in irreversible damage including paraplegia and is considered an oncological emergency. 

It is important that all health professionals are able to:

• recognise the signs and symptoms of metastatic spinal cord compression
• assess the severity
• initiate the right interventions and escalate care appropriately.

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Module

Case study podcast

Brooke Barrett was a graduate nurse when she was first exposed to MSCC. She shares career case studies of managing the serious oncological emergency and how her early experience has shaped her career in both the adult and paediatric setting. 

Continue your learning

• MSCC summary sheet opens in a new tab or window
• NICE Guideline - Spinal metastases and metastatic spinal cord compression opens in a new tab or window
• Metastatic spinal cord compression: a rare but important complication of cancer opens in a new tab or window
• eviQ clinical resources- ID 296 Palliative spinal cord compression (SCC) EBRT

Patient information

• National Institute for Health and Care Excellence (NICE) opens in a new tab or window: Information for the public- Metastatic spinal cord compression in adults: risk assessment, diagnosis and management.
• MacMillan Cancer Support- Cancer information and support opens in a new tab or window - Malignant spinal cord compression (MSCC)

Reference list

1. Robson, P. 2014. “Metastatic spinal cord compression: a rare but important complication of cancer.” Clinical 14(5): 542-545
2. NICE Guidelines. 2023. "Spinal metastases and metastatic spinal cord compression."
3. Cook, A. M., T. N. Lau, M. J. Tomlinson, et al. 1998. "Magnetic resonance imaging of the whole spine in suspected malignant spinal cord compression: impact on management." Clin Oncol (R Coll Radiol) 10(1):39-43.
4. Lawton AJ, Lee KA, Cheville AL, et al. 2017. “Assessment and Management of Patients with Metastatic Spinal Cord Compression: A Multidisciplinary Review.” J Clin Oncol 37(1):61-71
5. Patchell, R. A., P. A. Tibbs, W. F. Regine, et al. 2005. "Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial." Lancet 366(9486):643-648.
6. Conti A, Acker G, Kluge A, et al. 2019. “Decision Making in Patients With Metastatic Spine. The Role of Minimally Invasive Treatment Modalities.” Frontiers in oncology 9:915