Recommendations for management of spinal cord compression due to spinal metastasis: a systematic review of clinical practice guidelines.

• Grant number: 25/04572-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2025
• End date: May 31, 2026
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Crystian Bitencourt Soares de Oliveira
• Grantee: Rebeca Alessi Tedeschi Pachega
• Host Institution: Pró-Reitoria de Pesquisa e Pós-Graduação. Universidade do Oeste Paulista (UNOESTE). Presidente Prudente , SP, Brazil

Abstract

AbstractIntroduction: Metastatic spinal cord compression (MSCC) is defined as spinal cord strangulation with potential involvement of the cauda equina, resulting from a metastatic process or local cancerous injury, leading to irreversible neurological damage. It is estimated that 1 in 5 patients with MSCC is unaware of the primary tumor, presenting solely with localized spinal pain without any other clinical signs. Treatments are based on the patient's symptoms and guided by evidence-based clinical guidelines. However, numerous clinical guidelines have been published in recent years, and therefore, a review is necessary to identify consistencies, discrepancies, and areas that warrant future research.Objective: To compare clinical guideline recommendations for the diagnosis and treatment of spinal cord compression due to metastasis.Methods: The protocol will be registered on OSF.io and will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy will be conducted in electronic databases such as Medline, Embase, Cochrane, and CINAHL. A combination of keywords related to clinical guidelines and spinal cord compression in response to metastasis will be used. There will be no restriction on language or publication date. Two independent reviewers will perform study selection, data extraction (including diagnostic and treatment recommendations), and methodological quality assessment of the clinical guidelines (using the AGREE II tool). A descriptive analysis will be performed to assess the concordance between diagnostic and treatment recommendations across guidelines.Keywords: Management, Spinal cord compression, Metastasis.