Evidence
Surveillance decision
We will update the guideline on metastatic spinal cord compression in adults.
The following table gives an overview of how evidence identified in surveillance might affect each area of the guideline, including any proposed new areas.
|
Section of the guideline |
New evidence identified |
Impact |
|
1.1 Service configuration |
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|
Cancer networks |
Yes |
Yes |
|
1.3 Early detection |
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|
Early symptoms and signs |
Yes |
Yes |
|
1.4 Imaging |
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|
Choice of imaging modality |
Yes |
Yes |
|
Routine MRI and early detection |
Yes |
Yes |
|
1.5 Treatment |
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|
Analgesia |
Yes |
Yes |
|
Radiotherapy |
Yes |
Yes |
|
Vertebroplasty and kyphoplasty |
Yes |
Yes |
|
Surgery |
Yes |
Yes |
|
Mobilisation |
Yes |
Yes |
|
Corticosteroids |
Yes |
Yes |
|
Case selection – Age |
Yes |
Yes |
|
Technical factors of surgery |
Yes |
Yes |
|
1.6.5 Access to specialist rehabilitation and transition to care at home |
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|
Pathways |
Yes |
Yes |
|
New area |
||
|
Case selection – The role of scoring systems |
Yes |
Yes |
Reasons for the decision
This section provides a summary of the areas that will be updated and the reasons for the decision to update.
NICE's guideline on metastatic spinal cord compression in adults has not been updated since its publication in 2008. Feedback from topic experts and stakeholders highlighted that, since its publication, there have been advances in the diagnosis and management of metastatic spinal cord compression (MSCC) that are not reflected in the current recommendations. New evidence demonstrates that changes to multiple areas of the guideline are needed. The surveillance review considered published evidence from Cochrane reviews and NIHR Signals. Additionally, stakeholders and topic experts provided additional studies, information and clinical insight. Therefore, the guideline requires updating.
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