| CONSULT REQUEST GUIDELINES
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Painful Metastasis To Spine, But No Spinal Cord Compression
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| Suggested Pre-Referral Evaluation and Management Guidelines |
For patients with spinal instability:
- Imaging features in which instability may be present
- Fracture
- Retropulsed bone fragments, malalignment of vertebrae
- Very obvious kyphosis
- Neurosurgery consultation (see below) for surgical consideration:
- Open surgical stabilization
- Kyphoplasty
- Vertebroplasty
(Orthopadic Surgery and Radiology perform some of these procedures as well)
- Radiation Oncology consultation for radiation therapy
- Hematology Oncology evaluation, specially for newly diagnosed patients
- Consider systemic therapy
- Consider PM&R consultation
- Consider supportive or palliative care
For patients with no spinal instability:
- Radiation Oncology consultation for radiation therapy, or
- Hematology Oncology evaluation:
- Consider systemic therapy
- Consider PM&R consultation
- Consider supportive or palliative care
If intractable pain, consider neurosurgery consultation for kyphoplasty/vertebroplasty evaluation.
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| Suggested Additional Test/Management Prior to Specialty Visit |
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| Patient Education/Information (includes preps) |
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| Appointment Timeframe |
Neurosurgery Consultations: ER or inpatient pager 31777. Clinic consultations, please contact Paul Park, M.D. or Frank La Marca, M.D. directly by e-mail or page.
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.
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| 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
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| Revised on: |
09/05/2012 |
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