Abstract
Back ground: In patients with a history of systemic cancer(out side the spinal column) , presented
with persistent back pain, the early detection and management of spinal metastases is of utmost
important to help with pain control, prevent further spread and development of neurological
complications.
Objective: To determine and evaluate the importance of spinal percussion, as a physical sign , and as
evidence of spinal metastases.
Methods: A prospective study of 61 patients with a history of systemic cancer , presented with back
pain and suspicion of spinal metastases, was carried out.
Full medical history and physical examination, including entire spinal percussion with a reflex
hammer, were done for all patients.
All patients had ESR , serum alkaline phosphatase estimation and plain radiographic study of entire
spine.
All patients had MRI scanning.
Results: The spinal percussion sign profiling as a red flag, carried a high sensitivity of 90% and
specificity of 89.4% aiding in identifying the spinal metastases.
Conclusions: This test will help in prediction which patient with a history of primary cancer
presented with back pain , have a high possibility of spinal metastases that need the priority , or at
least to put them on the first line of waiting list of MRI for final diagnosis
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