Spinal cord compression

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 31, 2016
StartDiseasesSpinal cord compression

Spinal cord compression affects many people and most often results from aging, injury, or disease. Fortunately, healthy habits can be developed to prevent or reduce symptoms.

Contents

Definition & Facts

The central nervous system consists of the brain and spinal cord. The spinal cord contains nerves that relay electrical signals between the brain and the rest of the body. The spinal cord is protected by a column of backbones called vertebrae. The nerves of the spinal cord run through the openings between the vertebrae and out to the body.

Spinal cord compression is caused by pressure on the spinal cord resulting in nerve pain. Injuries, aging, and disease can compress the spinal cord, causing back pain, tingling sensations throughout the body, muscle weakness, and other neurological symptoms. Compression can develop anywhere along the spinal cord.

Symptoms & Complaints

Symptoms vary depending on the exact area and severity of the compression, and may become more serious as pressure on the spine increases over time. If compression is slight, mild symptoms are likely and include discomfort, mild back or neck pain, numbness, burning, stiffness, tingling, and slight weakness of the muscles.

Pain may be felt in different areas of the body, including the extremities. Difficulty walking and performing activities involving fine motor skills may be present. Symptoms can develop suddenly or gradually.

More substantial compression may result in severe muscle weakness, intense back or neck pain, loss of bladder control or loss of bowel control, severe numbness, loss of sexual function, or the inability to walk. If all the electrical signals are blocked, such as with a traumatic injury, loss of feeling, and paralysis can result.

Causes

Osteoarthritis is one of the most common causes of spinal cord compression. This gradual wear and tear on the bones of the spine usually presents itself after the age of 50. Additionally, bones that grow abnormally may compress the spinal cord.

If connective tissue lining the spinal canal hardens or thickens with age, compression may result. Over time, scoliosis can put pressure on the spinal cord. Herniated discs can cause compression and are often the result of disc degeneration, which happens as the body ages. The spinal discs lose some of their water content over time, resulting in a loss of flexibility and making them more prone to tearing or rupturing. 

Other conditions that may cause spinal cord compression can occur at any age. Cancer can spread to the spine and the resulting tumors can create pressure. A bleeding disorder, such as a hematoma, can cause blood to accumulate inside the spinal column, and injuries to the spine, such as broken bones or dislocated bones, can cause compression. Disc herniation that is not the result of aging can occur by using back muscles to lift heavy objects instead of leg muscles. Twisting and turning while lifting can also cause discs to rupture.

Diagnosis & Tests

To determine the cause of spinal cord compression, the doctor will conduct physical examinations and neurological examinations that include medical history questions and tests for brain, spinal cord, and nerve function. A check for coordination, muscle strength, and reflexes will also be carried out.

The patient's posture, balance, and gait will be assessed. The doctor can determine which part of the spinal cord is affected based on the symptoms and results of the physical examination. The location of pain or tenderness along the spine also assists doctors in pinpointing the location of the damage.

Imaging tests may be used to diagnose spinal cord compression. These include magnetic resonance imaging (MRI) and computed tomography (CT) scans. A myelography may be ordered if MRI and CT scans are unavailable.

During this procedure, a dye is injected into the spinal fluid in the spinal canal, and an X-ray is taken. The doctor can then determine whether the compression is completely blocking the flow of spinal fluid. X-rays can also show bone spurs that may be pressing against nerves, as well as abnormal alignment in the backbone. Imaging tests can show where the spine is compressed, and may indicate the cause.

A bone scan or EMG may be performed. Prompt diagnosis and treatment may reverse or lessen the loss of function. 

Treatment & Therapy

Treatment for spinal cord compression will depend on the cause. The goal of treatment is to relieve pain promptly and to protect nerves from irreversible damage. Physical therapists, bone surgeons, cancer specialists, or nerve specialists may become involved with treatment.

Treatment includes medication, physical therapy, injections, and surgery. Anti-inflammatory medication and steroid injections may reduce swelling and pain to treat symptoms. Physical therapists may teach the patient exercises which strengthen the abdominal, neck, and/or leg muscles resulting in a reduction in symptoms.

Surgical treatments may be employed to remove bone spurs or to widen the space between vertebrae. Surgery may also be utilized to relieve pressure on the spine or to repair fractured vertebrae. The back may require stabilization by fusing some vertebrae together.

If cancer is the cause of compression, surgery or radiation to remove tumors will be done. In the case of a hematoma, the blood will be drained as quickly as possible, and the patient will be given treatment to reduce or eliminate the cause of bleeding.

Prevention & Prophylaxis

Although some causes of spinal cord compression cannot be prevented, symptoms of spinal cord compression caused by gradual wear and tear can be reduced by maintaining a strong and healthy back. This can be accomplished through regular exercise which strengthens the muscles that support the back. Exercise to keep the spine flexible as well as maintenance of good posture and the use of careful lifting procedures are beneficial.

Sleeping on a firm mattress and sitting in a chair that supports the back also contribute to good spinal cord health. Eating a nutritious diet and maintaining healthy weight will prevent excess stress on the back. Prevention of accidents through safe driving habits, avoidance of alcohol, and following safety procedures are other ways to prevent back problems.