Complications of spinal cord irradiation
- Kevin Oh, MD
Kevin Oh, MD
- Assistant Professor of Radiation Oncology
- Harvard Medical School
- Attending Radiation Oncologist
- Massachusetts General Hospital
Radiation therapy can cause toxicity to either the central or peripheral nervous system when these structures are included in the treatment field. Nervous system toxicity is usually subdivided into acute (during the course of radiation), early delayed (weeks to three months after radiation), and delayed reaction (more than three months).
Several syndromes of radiation injury to the spinal cord have been described, the most prominent of which are a self-limited transient myelopathy and the more serious chronic progressive myelopathy. Other more disabling manifestations of radiation injury, including acute paralysis secondary to ischemia, hemorrhage within the spinal cord, and a lower motor neuron syndrome, are much less common, with only a few case reports in the literature [1,2].
The complications that can occur following irradiation of the spinal cord will be reviewed here. Other relevant topics include:
●Complications of irradiation of peripheral nerves (see "Brachial plexus syndromes", section on 'Neoplastic and radiation-induced brachial plexopathy' and "Lumbosacral plexus syndromes", section on 'Radiation plexopathy')
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- EARLY RADIATION-INDUCED MYELOPATHY
- LATE RADIATION-INDUCED MYELOPATHY
- Pathology and pathogenesis
- Radiation dose-volume effects and risk
- - Fractionated radiation
- - Hypofractionated radiation
- - Re-irradiation
- Clinical presentation
- Risk factors
- OTHER LATE COMPLICATIONS
- Lower motor neuron syndrome
- Spinal cord hemorrhage