Spinal cord compression (patient information)

The spinal cord provides nerves to the body including the bladder, arms, and legs. If there is a mass like structure in the bones of the spine (vertebrae) or in the tissues around the spinal cord it can cause pressure (compression) on the spinal cord. This can cause pain, altered sensation and weakness. Spinal cord compression is not common usually but happens to one in 20 people affected by cancer.

• Back pain
• Increased muscle tone (spasticity)
• Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
• Numbness
• Sensory changes
• Weakness
• Paralysis

• Any trauma to back
• Tumor
• Disc prolapse
• Vertebral compression fractures
• An abscess or blood clot around the spine

People with underlying spine disease are at high risk of developing spinal cord compression than normal people.

• Cervical spondylosis
• Atlantoaxial instability
• Congenital conditions (tethered cord)
• Osteoporosis
• Ankylosing spondylitis
• Rheumatoid arthritis of the cervical spine

A physical examination shows point tenderness, muscle weakness and loss of reflexes. Tests may include:

• Complete blood count (CBC)
• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)
• MRI of the bone

Call your health care provider if:

• You develop symptoms of spinal cord compression

Surgery is the mainstay of treatment in localized compression. Emergency radiation therapy (usually 20 Gray in 5 fractions) is the mainstay of treatment for malignant spinal cord compression. It is very effective as pain control and local disease control. Some tumors are highly sensitive to chemotherapy (e.g. lymphomas, small cell lung cancer) and may be treated with chemotherapy alone.

Directions to Hospitals Treating spinal cord compression

• Proper safety practices during work can prevent spinal cord injuries.

• Prognosis is poor even with adequate treatment if the syndrome is complete (quadriparesis and with no sensory preservation), and recovery is less than 5%.

• Pressure ulcers
• Clots in the lungs
• Urinary tract infections
• MRSA infection

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