CONSULT REQUEST GUIDELINES                                                                         Print

Spinal Cord Compression

Suggested Pre-Referral Evaluation and Management Guidelines
 - Complete spine MRI if not already done
 - High Dose* Steroids (considering clinical context)
 - Consult with appropriate oncology team, if patient already has an oncologist

*High Dose Steroids: Decadron 96 mg IV x 1, then 24 mg IV q6hrs until treatment (surgery or RT begun). Moderate Dose Steroids: Decadron 10-20mg IVx1 then 6mg PO/IV q6hrs. Weaned as appropriate after treatment begun. Adjustments should be made as necessary taking into account overall medical history and current condition (i.e., diabetes, ulcers, etc.).
Suggested Additional Test/Management Prior to Specialty Visit Emergent Radiation Oncology and Neurosurgery consultations

Facts favoring surgery:
  • Spinal Instability
  • Significant back pain at tumor site
  • Previous RT
  • Rapid neurologic deterioration
  • No previous cancer diagnosis
  • Tumor biology: "Radioresistant", not lymphoma/myeloma
  • Single site of compression (can be several contiguous vertebral levels)
Favorable Surgical Candidates:
  • Surgical resection/stabilization
  • Refer for Radiation Therapy post-operatively
  • Consult Hematology Oncology, especially for new diagnosed patients.
    • Consider systemic therapy
    • Consider PM&R consultation
    • Consider supportive or palliative care
Unfavorable Surgical Candidates:
  • Refer to Radiation Therapy directly
  • Consult Hematology Oncology, especially for new diagnosed patients.
    • Consider systemic therapy
    • Consider PM&R consultation
    • Consider supportive or palliative care
Patient Education/Information (includes preps)  
Appointment Timeframe Neurosurgery Consultations: ER or inpatient pager 31777. Please contact our referral office at 734-936-7010.
Radiation Oncology Consultations: ER or inpatients, refer to on-call paging system. For clinic consultations, route through Radiation Oncology scheduling office at (734) 936-4300.
Please complete Consult Request form and fax to 734-647-9233.
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Hand carry non-UM records to visit
Clinic Contact Information Physicians: 800-962-3555
For Patients:
    734-936-7010 Neurosurgery
    734-936-4300 Radiation Oncology
Clinic Location Sites Neurosurgery
Radiation Oncology
UM Consulting Physician Spine Neurosurgery Program Faculty
Radiation Oncology Faculty
Revised on: 12/12/2014
 
 

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