Spinal MRI in Patients with Suspected Metastatic Spinal Cord Compression: A Quality Improvement Audit in a District General Hospital in Kent, UK

Michel-Elie Bachour, Rukhshana Dina Rabbani, Mahmudul Rahat Hasan, Sumaya Akter, Premsai Chilakuluri, Soirindhri Banerjee, Aruni Ghose, Elisabet Sanchez, Temitayo Ahmadu, Vasileios Papadopoulos, Jennifer Teke, David Bamidele Olawade, Saak Victor Ovsepian and Stergios Boussios ()
Additional contact information
Michel-Elie Bachour: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Rukhshana Dina Rabbani: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Mahmudul Rahat Hasan: Department of Acute Medicine, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Sumaya Akter: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Premsai Chilakuluri: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Soirindhri Banerjee: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Aruni Ghose: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Elisabet Sanchez: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Temitayo Ahmadu: Kent Medway Medical School, University of Kent, Canterbury CT2 7LX, UK
Vasileios Papadopoulos: Department of Urology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Jennifer Teke: Department of Research and Innovation, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
David Bamidele Olawade: Department of Research and Innovation, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
Saak Victor Ovsepian: Faculty of Engineering and Science, University of Greenwich London, Chatham Maritime ME4 4TB, UK
Stergios Boussios: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK

IJERPH, 2025, vol. 22, issue 3, 1-11

Abstract: Metastatic spinal cord compression (MSCC) is a common complication in cancer patients, occurring in 3–5% of diagnosed cases annually, and serves as the initial manifestation of malignancy in 20% of patients. Timely diagnosis and management are critical due to the risk of irreversible neurological damage and the significant impact on both quality and quantity of life. The National Institute for Health and Care Excellence (NICE) recommends that patients presenting with back pain accompanied by neurological signs and/or symptoms undergo whole-spine magnetic resonance imaging (MRI) within 24 h. This retrospective study at Medway Maritime Hospital in England aimed to assess adherence to these guidelines by reviewing the time from presentation to MRI for patients exhibiting symptoms and/or signs of MSCC. Data for 69 patients were collected over one year using electronic patient records and the acute oncology service database. Analysis revealed that MRI was conducted within 24 h in only 43 out of 69 cases (62%), and 16 out of 25 delayed cases (i.e., MRI done beyond the recommended 24 h window) experienced delays of more than 48 h. To improve guideline adherence, interventions such as informational flyers and regular MSCC training sessions, including trainee teaching and presentations during grand rounds, were implemented. A follow-up re-audit involving 113 patients over one year demonstrated improved adherence to the 24 h MRI guideline, with 81 out of 113 cases (71%) meeting the target. The second cycle also documented reasons for delays, identifying patient compliance and pain control as primary factors. Additionally, the timing of steroid administration following suspicion of MSCC was recorded. Future studies should re-assess adherence, focus on better documentation of delay causes, enhance pain management before MRI scans, and ensure prompt steroid administration.

Keywords: metastatic spinal cord compression; magnetic resonance imaging; corticosteroids; decompressive surgery; palliative radiotherapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/22/3/401/pdf (application/pdf)
https://www.mdpi.com/1660-4601/22/3/401/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:22:y:2025:i:3:p:401-:d:1608847

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().