Info for Referring Physicians

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	Consult Request Guidelines for Evaluation of Suspected Spine Metastasis/Cord Compression	Print This Page Close Window

Evaluation of Suspected Spine Metastasis/Cord Compression
Suggested Pre-Referral Evaluation and Management Guidelines	Patients with history of cancer at any time (consider cancer in differential diagnosis of new onset back pain or neuro symptoms. New back pain and/or neurologic symptoms (myelopathy or radiculopathy)
Suggested Additional Test/Management Prior to Specialty Visit	Neuro Exam (including limb examination of strength, sensation, reflexes, rectal tone (as indicated), and urinary function as indicated. Any one or combination of weakness, numbness, incontinence, or urinary retention (e.g., PVR >100) Schedule emergent spine MRI. Administer corticosteroids (Moderate or High Dose) Schedule emergent neurology or neurosurgery consultation pain control See Spinal Cord Compression, Painful Metastasis To Spine, But No Spinal Cord Compression, or No Vertebral or Epidural Tumor guidelines If no neuro deficits, schedule urgent Spine MRI (<=24 hours) 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.).
Patient Education/Information (includes preps)
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.
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:	09/05/2012