What immediate management steps should be taken in the primary care setting for a patient presenting with MSCC?

Immediately start immobilisation without delay for people with suspected or confirmed MSCC and neurological symptoms or signs suggesting spinal instability ¹.

Consider immobilisation for people with suspected or confirmed spinal metastases or MSCC and moderate to severe pain associated with movement ¹.

Seek early advice (within 24 hours) from an expert clinician, such as a specialist physiotherapist, oncologist, or spinal surgeon, and start assessment of spinal stability to minimise the duration of immobilisation, if appropriate ¹.

Arrange urgent radiological imaging of the spine, preferably MRI, overseen by a radiologist to ensure appropriate and complete imaging and urgent reporting ¹.