Spinal cord compression: from laboratory to clinic.

摘要: INTRODUCTION THE MAGNITUDE of the clinical problem neoplastic spinal cord compression (SCC) is usually underestimated. The estimated annual incidence cancer-induced injury in U.S.A. 8.5 per 100 000 [ 11, which exceeds calculated rate traumatic (three to five 000). Since SCC itself generally not fatal (excluding upper portion cervical spine), treatment aimed at preserving or restoring ambulation and continence, alleviating intractable pain. Approximately 50% cases metastatic epidural adults arise from breast, lung prostatic cancer [2-51, while children most common tumour types are different. Sarcomas neuroblastomas comprise more than 80% all paediatric [2, 6, 71, tumours invade canal via neural foramen rather vertebral destruction mode for invasion adults. These variances dictate therapeutic approaches tailored match different tumour, but functional outcome still depends on same pathophysiological mechanism operating both age groups. last two decades have witnessed significant shifts approaches, ranging between urgent decompressive surgery non-surgical treatments [8]. Regardless modality use, less patients with ever walk again [8], even prompt decompression does guarantee neurological recovery. that determines degree irreversible tissue damage poorly understood, appears be associated endogenous neurochemical changes resulting initial event compressive injury. Therefore, it seems crucial link strategies alleviate mechanical tactics designed limit secondary autodestructive processes compressed leading neuronal cell death permanent loss function. Comprehension cascade ‘activated by has been expanded use newly characterised animal models enable better understanding a cellular level [+21]. recognition