Neck pain secondary to malignant disease/infection

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

  • Presence and duration of neurological symptoms and signs including evidence of lower limb spasticity
  • Work status
  • Weight loss, appetite loss and lethargy
  • Fever and sweats
  • Treatment to date
  • Previous malignant disease
  • General medical condition

Tests

Investigations (only if indicated):

  • Plain x-ray & CT
  • FBC/CRP & ESR
  • Consider calcium and phosphate, protein
  • electrophoresis, immunoglobulins, PSA
  • Rheumatoid serology in specific cases
  • Will require MRI (Neurosurgery to arrange)
  • Prior to referral is CT? negative/normal

Interim/GP management

To refer a patient with this condition, please see the Neurosurgery clinic page for the full referral process and templates.

  • Contact Registrar on-call for advice

For more information please see the Tasmanian Health Pathways website.

Emergency

Significant Cord Compression with severe or rapidly progressive deficit

Urgent / category 1

Myelopathy

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED
– Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED
– Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED
– Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED
– Phone: (03) 6166 6100  Fax: (03) 6173 0489 - Phone the Neurosurgery Registrar on call via Switch (03) 6166 8308 and/or send to RHH DEM

Urgent:

Urgent cases must be discussed with the Neurosurgery Registrar on call to obtain appropriate prioritisation and a referral faxed to (03) 6173 0491

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment