The onset of neurologic symptoms may be preceded by progressive back pain for several weeks.
The most important prognostic factor in outcome is the neurologic status at the time of decompressive surgery.
Delay in diagnosis:
(1) misdiagnosis as herniated disc, especially in a patient with a past history of back pain
(2) failure to investigate
(3) failure to refer
(4) no previous history of cancer
Delay in management:
(1) failure to manage neurologic symptoms as a potential emergency
(2) failure to appreciate how fast the patient can progress
(3) delay in transfer to a hospital where surgery can be performed
Complications of a delay in diagnosis or management:
(1) inability to walk
(2) incontinence of bladder and/or bowels
