119 PCN Malignant Epidural Spinal Cord Compression (MESCC)
- Surgery Indications:
- Spinal instability
- Previous RT
- Worse despite RT
- Radioresistant tumor
- Unknown primary
- Paraplegia less than 48 hrs
- Single area of compression
- Steroid dosing: dexamethasone
- “high dose” – if neuro exam abnormal
- 96 mg bolus IV, 24 q 6 hr po x 3 days
- 10 day taper
- “moderate dose” – all others
- 10 mg bolus IV, 4 qid
- 2 week taper
- “high dose” – if neuro exam abnormal