TY - JOUR T1 - How not to miss metastatic spinal cord compression JF - British Journal of General Practice JO - Br J Gen Pract SP - e596 LP - e598 DO - 10.3399/bjgp14X681589 VL - 64 IS - 626 AU - Chitra Nair AU - Shrijit Panikkar AU - Arupratan Ray Y1 - 2014/09/01 UR - http://bjgp.org/content/64/626/e596.abstract N2 - The National Institute for Health and Care Excellence (NICE) estimates that each year in the UK around 2.5 million people will approach their GP with back pain. Fortunately most cases are due to non-specific causes and are often self-limiting.Metastatic spinal cord compression (MSCC) is one of the ominous causes of back pain where there is a compression of the thecal sac and its components by tumour mass. This is a true spinal emergency, and if the pressure on the spinal cord is not relieved quickly, it may result in irreversible loss of neurologic function. The most important prognostic factor for functional outcome is neurologic function before treatment.1 Hence, any delay could result in poorer functional outcome and decreased quality of life, with increased dependence on healthcare resources. There is a need for improving awareness among all clinicians so as to make prompt diagnosis and referral of MSCC a reality.2Bone is the third most common site of metastases after the liver and the lung. MSCC is seen in up to 5% of cancer patients; however, in up to 20% of MSCC cases, cord compression may be the first sign of malignancy.3 Although the exact incidence of MSCC is not known, intelligent estimates put the number at about approximately 4000 cases in England and Wales.4The most common primary tumours that metastasize to the spine are breast, lung, prostate, and kidney tumours. Tumours may spread to the … ER -