Spinal Cord Compression

Dr Tom Leach

8 years ago

Contents

The spinal cord runs from C1 (junction with the medulla), to about L1, where it becomes the cauda equina.
- Note that it terminates lower down in children – the spinal cord cannot grow as well as the rest of the body!
The spinal cord gets its blood supply mainly from the vertebral arteries.

Degenerative disc lesions, e.g. Herniated disc
Degenerative vertebral lesions, e.g. Osteoporosis
TB
- The most common cause of spinal cord compression in countries where TB is common
- There is destruction of both the disc and the vertebra
- Paralysis can occur – in which case it is called Pott’s Paraplegia
Epidural abscess
Vertebral neoplasms:
- Myeloma
- Metastasis – Bone, Bronchus, Prostate, Lymphoma, Thyroid
- Menningioma
- Neurofibroma
- Ependymoma
- Glioma
- Lipoma
- Teratoma
- Symptoms will occur gradually over months, perhaps even years with slow growing tumours (e.g. glioma). There will usually be root pain and an obvious sensory level.
Epidural haemorrhage
Paget’s disease

Spinal cord compression at T4

Pain radiates around the thorax, typically worse on coughing
Spastic paraparesis develops slowly of the following hours days or weeks depending on the underlying pathology
Numbness from the feet to the level affected
Urinary Retention
Constipation

It is a medical emergency
Can be difficult to differentiate a chronic from an acute cause, particularly if pain and sensory level are ambiguous.