Complications
Loss of sensation and poor mobility combine to put pressure points at risk.
Autonomic function is transmitted in the anterior interomedial tract. Progressively higher spinal cord lesions cause increasing degrees of autonomic dysfunction. Symptoms suggesting autonomic dysfunction include orthostatic hypotension, heat intolerance, loss of bladder and bowel control, and erectile dysfunction.
Patients with solid tumours being treated for MSCC are at risk for pneumocystis jirovecii pneumonia due to corticosteroid treatment.[101]
Patients with active cancer, and especially metastases, are at increased risk of deep vein thrombosis.[95] This risk is further increased in patients with MSCC by immobility and surgery.[96] Anticoagulation and mechanical thromboprophylaxis using compression stockings or intermittent compression devices are used for both prevention and treatment.[97]
Patients with limb weakness and sensory impairments are at risk for falls, which may result in further injury. Patients with neurological symptoms should be evaluated for fall risk and a suitable management plan initiated. Management may include targeted physical and occupational therapy to work on strength, transfers (i.e., from bed to chair, from chair to commode, etc), stamina, balance, range of motion, and activities of daily living.[56][102] Some patients may benefit from the use of bracing and assistive devices to minimise fall risk.
Patients with poor bladder emptying are at risk from developing retrograde influx of organisms and infection.
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