What are the key clinical features that suggest a diagnosis of metastatic spinal cord compression (MSCC) in a patient?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

When considering a diagnosis of metastatic spinal cord compression (MSCC), particularly in patients with a past, current, or suspected diagnosis of cancer, several key clinical features should prompt suspicion . These symptoms and signs directly suggest cord compression:

  • Bladder or bowel dysfunction .
  • Gait disturbance or difficulty walking .
  • Limb weakness .
  • Neurological signs of spinal cord or cauda equina compression .
  • Numbness, paraesthesia, or sensory loss .
  • Radicular pain .

If a patient with a past or current diagnosis of cancer presents with these symptoms or signs of cord compression, it should be treated as an oncological emergency, and the MSCC coordinator should be contacted immediately .

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