What are the potential complications of untreated MSCC that I should be aware of in my clinical practice?

Potential complications of untreated metastatic spinal cord compression (MSCC) include:

• Progressive neurological decline leading to limb weakness and paralysis (paraplegia or tetraplegia), which may become irreversible if not treated promptly.
• Bladder and bowel dysfunction due to spinal cord involvement, resulting in incontinence or retention.
• Severe, unremitting back pain that worsens with movement or straining, significantly impairing quality of life.
• Gait disturbance and difficulty walking, increasing the risk of falls and further injury.
• Loss of sensory function including numbness, paraesthesia, or radicular pain.
• Spinal instability causing mechanical pain and potential vertebral collapse.
• Overall loss of independence and reduced quality of life due to the above complications.

These complications highlight the importance of early recognition and urgent referral for treatment, as MSCC is considered an oncological emergency requiring prompt intervention to prevent permanent neurological damage ¹.