How do you approach the management of a patient with lumbar spinal metastasis with neurologic symptoms but without evidence of spinal cord compression?  

In a patient with metastatic cancer to the lumbar spine and epidural disease on CT who presents back pain and leg weakness:

  1. Is a whole spine MRI indicated?
  2. Within how many hours should palliative RT be completed?

Answer from: Radiation Oncologist at Academic Institution