In spinal metastases : spinal percussion is profiling as predictor and a red flag in patients present with back pain

Abstract EN

Back ground : In patients with a history of systemic cancer(out side the spinal column) , presented with persistent back pain, the early detection and management of spinal metastases is of utmost important to help with pain control, prevent further spread and development of neurological complications.

Objective : To determine and evaluate the importance of spinal percussion, as a physical sign , and as evidence of spinal metastases.

Methods : A prospective study of 61 patients with a history of systemic cancer , presented with back pain and suspicion of spinal metastases, was carried out.

Full medical history and physical examination, including entire spinal percussion with a reflex hammer, were done for all patients.

All patients had ESR, serum alkaline phosphatase estimation and plain radiographic study of entire spine.

All patients had MRI scanning.

Results : The spinal percussion sign profiling as a red flag, carried a high sensitivity of 90 % and specificity of 89.4 % aiding in identifying the spinal metastases.

Conclusions : This test will help in prediction which patient with a history of primary cancer presented with back pain, have a high possibility of spinal metastases that need the priority, or at least to put them on the first line of waiting list of MRI for final diagnosis.