Table 1.

Symptoms of spinal cord compression by tumour location.

Metastasis Location	Signs and Symptoms
Cervical spine	Headache, neckache, shoulder/arm pain Loss of upper limb sensation Weakness of neck, trunk, and upper limb muscles Paresis/paralysis involving the neck, trunk, and upper limbs
Thoracic spine	Chest and/or back pain Decreased sensation below the tumour level/Increased sensation above the tumour level Muscle weakness below the tumour level Paresis/paralysis Bladder, bowel, sexual dysfunction Positive Babinski reflex
Lumbosacral spine	Low back pain ± radiculopathy Lower limb muscle weakness Lower limb muscle paresis/paralysis Decreased or absent lower limb reflexes Drop foot Decreased or absent lower limb reflexes Bladder, bowel, sexual dysfunction Cauda equina syndrome—perineal/perianal loss of sensation (“saddle anaesthesia”), loss of rectal tone, absent bulbocavernosus, and anal wink reflexes