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Spinal Cord Compression - Causes, Symptoms, Diagnosis, and Treatment Strategies

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Spinal cord compression is a condition where physical pressure on the spinal cord somewhere on its path causes pain, weakness, and numbness in the body parts.

Written by

Dr. Jayasree S

Medically reviewed by

Dr. Abhishek Juneja

Published At October 6, 2022
Reviewed AtOctober 7, 2022

What Is Spinal Cord Compression?

The spinal cord is the continuation of the brain, which is surrounded and protected by a stack of bones called vertebrae. A spinal cord compression occurs when a mass places pressure on the spinal cord. It can be a tumor, a bone fragment, or something else. From the starting point in the neck to where it ends at the lower back, the spinal cord may get compressed anywhere on its path. One may suffer numbness, pain, and weakness anywhere in the body, depending on the area of compression. And the symptoms may progress suddenly or over a long period depending upon what causes the compression.

What Are the Causes of Spinal Cord Compression?

The spinal cord starts from the upper part of the neck and ends below the ribcage, continuing as a bunch of nerve fibers. Many nerve roots emerge from either side of the spinal cord and branch out to reach every part of the body. These are the nerves sending signals to the muscles and taking sensations back to the brain. Any cause that applies physical pressure on the nerve on its path from the neck to the lower back affects the body in different ways. Spinal cord compression has many possible causes, such as:

  • Cancerous or noncancerous tumors grow in the space near the spinal cord and put pressure or compression.

  • Degenerative diseases like arthritis or others.

  • A ruptured intervertebral disc (a part that acts as a cushion between the bones forming the spine). It may cause compression or injury to the spinal cord.

  • The formation of bony spikes (bone spurs) on vertebrae can narrow the spinal canal, causing compression.

  • Gradual wear and tear of the bones due to old age (osteoarthritis).

  • Abnormally aligned spine (scoliosis).

  • Immune system disorders like rheumatoid arthritis.

  • Infection involving the spinal cord.

What Are the Symptoms of Spinal Cord Compression?

Symptoms depend on how severe the compression is and what area of the spinal cord is compressed. If the underlying cause is some type of injury, one may show immediate symptoms. At the same time, tumors or infections may take days or weeks to start showing symptoms. Age-related wear and tear of the spine may take years to develop symptoms. The following are the expected symptoms:

  1. Stiffness or pain in the back, neck or lower back is a very prominent symptom.

  2. A burning pain extends to the arms, lower back, buttocks, and down the legs (sciatic pain).

  3. Numbness or weakness in legs, hands, or arms.

  4. Loss of sensation in both feet.

  5. Sexual dysfunction.

  6. If the compression is in the lower back (lumbar region), one may acquire a condition known as Cauda equina syndrome, which includes severe pain and weakness in the legs, loss of bowel and bladder control, and sweating on the back of the legs and inner thighs.

  7. Compression of the spinal cord in the lower back (lumbar region) affects walking and coordination. One may suffer a foot drop where the foot goes limp and weak.

How Is Spinal Cord Compression Diagnosed?

The doctor reviews the medical history and asks questions about the nature of the symptoms. This is followed by a thorough physical examination, where one looks for the possible signs of spinal cord compression. A neurological examination helps identify weakness, abnormal reflexes, and loss of sensation in body parts. It gives the doctor an idea about which area of the spinal cord may be compressed. The additional tests are:

  • X-ray- X-ray of the spine to visualize bone spurs pushing against the spinal cord and other abnormalities with spine alignment.

  • Computed Tomography (CT) Scan or Magnetic Resonance Imaging (MRI): These may help get a detailed view of the spinal cord, surrounding bones, and any underlying issues that cause compression.

  • Myelogram: A myelogram test, where a substance called contrasting dye is injected into the spinal canal, performs a CT scan to trace the abnormalities better.

  • Electromyography (EMG): This procedure helps test the strength of electrical signals passing from nerves to muscles which are indicative of the level of mobility and muscle weakness.

What Are the Treatment Options for Spinal Cord Compression?

It takes a team of multiple specialists from different healthcare specialties to bring the best outcomes. The team includes bone surgeons, neurologists, arthritis specialists, and physical therapists. Treatment depends upon the cause and severity of compression. The doctors may advise the affected individual to reduce physical activity and mobility for a while. One may opt for:

  1. Prescribing anti-inflammatory drugs or steroids to reduce pain and inflammatory swelling.

  2. Steroid injections into the spinal column (epidural steroid injection).

  3. Physical therapy to strengthen the abdominal, back, and leg muscles; may help decrease the symptoms.

  4. Orthodontic braces and neck collars might provide support and help relieve the symptoms.

  5. Homecare remedies such as applying ice packs and heating pads to relieve pain and swelling.

  6. Acupuncture, acupressure, and chiropractic manipulations may also help sometimes.

  7. Radiation or chemotherapy to shrink a tumor that compresses the spinal cord.

  8. Depending on the cause of compression, one may conduct surgical procedures, which include fusing two vertebrae, removing the bone spur, or increasing the space between two vertebrae (laminectomy, discectomy, or spinal fusion). One may do a surgical repair of fractured vertebrae as well. Surgical management involving the spine is very complicated, and they opt for it as a last resort in most cases.

Conclusion:

With spinal cord compression, some individuals respond well to treatment, though some do not. In order to prevent spinal cord compression from wear and tear of the bones, one can do a few things. Exercising regularly helps strengthen the back muscles so that the spine stays strong and flexible. Always try to adopt a proper body posture while sitting, standing, or lying down; for this, one can use firm mattresses, pillows, and chairs that align well with the natural curves of one’s back. Maintaining healthy body weight is also important, as being overweight and obese adds more stress on one's backbone and gradually compresses the spinal cord. A healthcare professional can advise on the proper ways to lift heavy objects without hurting the back, which is important too.

Frequently Asked Questions

1.

What Is the Result of Spinal Cord Compression?

A spinal cord compression can occur due to a mass such as a tumor, bone fragment, etc putting pressure on the spinal cord, causing numbness, weakness, or pain depending on the area of compression. If the mass is persistent, the symptoms can worsen gradually. 

2.

How Is Spinal Compression Managed?

Spinal cord compression is managed by multiple specialists, including orthopedics, surgeons, physiotherapists, and rheumatologists, bringing the best patient outcomes. Anti-inflammatory drugs to reduce pain and steroid injections for reducing swelling are done as pharmacological management. Orthodontic braces and collars are provided for neck support, and chemotherapy in case of tumors is suggested. 

3.

Can Spinal Cord Compression Be Reversed?

Spinal cord compression, if identified early and treated swiftly, can prevent permanent damage to the spinal cord. It can also help restore function of spinal nerves and the spinal cord. To relieve the compression, surgery is usually required. 

4.

Is It Possible for Spinal Compression to Heal on Its Own?

Compression fractures can frequently heal on their own within a timespan of three months. In most cases, surgery will not be required. Meanwhile, a neck collar or back braces can be used for support. Home remedies like placing an ice pack and heating pads to alleviate pain and swelling. Painkillers and steroid injections are used for pharmacological management in easing the symptoms. 

5.

How Long Does a Compressed Spinal Cord Take To Recover?

Recovery from spinal cord compression is based on the level and severity of the compression. Six months has been the fastest recovery time, and in severe cases, it might take a year or two to regain function fully. Certain untreated cases can heal on their own within three months. 

6.

Does Spinal Compression Cause Paralysis?

Based on the severity and compression levels, a patient's symptoms may be presented. If all the nerve impulses are blocked due to spinal cord compression, paralysis can occur. If paralysis occurs in the neck, breathing might become difficult for the affected individual. 

7.

How Long Can a Person With Spinal Cord Compression Live?

If the patient is on ventilator support and is over 60 years old, the life expectancy is up to two years. If the motor function is preserved and the patient is around 20 years of age, then the life expectancy is up to 50 years.

8.

Is It Possible for an MRI to Detect Spinal Cord Compression?

Yes, an MRI (magnetic resonance imaging) can help detect spinal cord compression. They help provide a detailed image of the spinal cord and surrounding structures, which helps doctors identify spinal cord compression and other related abnormalities.

9.

Does Spinal Cord Compression Lead To Stroke?

No, spinal cord compression does not directly lead to a stroke. Stroke can be precipitated by a loss of blood supply to the brain. However, symptoms of spinal cord compression can mimic symptoms of stroke. 

10.

How Is Spinal Compression Diagnosed?

The physician diagnoses spinal compression after reviewing the medical history and studying the nature of the symptoms. Additional tests like X-ray, MRI (magnetic resonance imaging), CT (computed tomography) scan, myelography, and electromyography (EMG) are necessary to identify the extent and severity of spinal compression. 

11.

Is Spinal Cord Compression Due to a Neurological Cause?

Yes, spinal cord compression is due to neurological factors and structural abnormalities, including spinal stenosis, spinal infections, tumors, herniated discs, and other spinal inflammatory conditions like rheumatoid arthritis and ankylosing spondylitis.

12.

Is Spinal Cord Compression Frequent?

The prevalence of spinal cord compression can be identified based on factors like tumors, spinal stenosis, and herniated discs. In older individuals, spinal cord compression is common due to age-related degenerative changes to the spine. In patients with spinal tumors, there is a 3 % to 5 % chance of acquiring spinal cord compression.
Dr. Abhishek Juneja
Dr. Abhishek Juneja

Neurology

Tags:

spinal cord compressionspinal stenosis
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