Neoplastic compressive myelopathy – Medicine MCQ

Which of the following is false regarding neoplastic compressive myelopathy?
A. Most neoplasms are subdural in origin
B. Thoracic spine is most commonly involved
C. Tumor does not cross the disk space to involve adjacent vertebral body
D. Prognosis is poor when motor deficits are established for > 48 hours

Correct answer: A. Most neoplasms are subdural in origin

Explanation:

• Any malignant tumour can metastasise to spinal columns, particularly tumours of breast, lung, prostate, kidney, lymphoma and myeloma.
• The most common site is the thoracic spinal column.
• Most neoplasms are epidural in origin, resulting from metastases to adjacent vertebral body.
• Unlike infections of the spinal column, the tumours do not cross the disk space.

Reference: Harrison’s Principles of Internal Medicine, 19th edition, p2653