Spinal Cord Compression

Spinal cord compression symptoms may come on suddenly or gradually, depending on what’s causing the pressure. Years of wear and tear on the spine may cause a gradual worsening of the condition, but the symptoms may be overlooked for quite some time. A tumor or an infection can cause symptoms to show up within a few days or weeks. A spinal cord injury or a hematoma (accumulation of blood) on the spine can cause sudden neurological symptoms.

If the compression on the spinal cord affects only a few nerves, you may notice only mild symptoms, which include:

• Pain and stiffness in the neck or lower back that might radiate to an arm, hand, leg or foot

• Numbness or tingling in the fingers, toes, hands or arms

• Weakness in the arms, shoulders or hands

• Tenderness in the area, which is often caused by a tumor, an abscess (caused by an infection) or a hematoma

• Breathing problems, blood pressure problems, or body temperature control problems, if the compression was caused by an injury

• Erectile dysfunction

Spinal cord compression in the lower back can cause the disorder cauda equina syndrome. If you experience the following symptoms, get immediate medical attention or call 911.

• Bladder or bowel control problems, causing either inability to urinate or defecate, or urine or stool leakage

• Severe or worsening pain, weakness or numbness in the lower extremities, such as between the legs and inner thighs and in the back of the legs

Any condition that puts pressure on the spinal cord can cause spinal cord compression. Some of the most common spinal cord compression causes include:

• Injury: A back injury is the most common cause of spinal cord compression. An injury can cause a fracture or dislocation of a vertebra, and that vertebra can put pressure on the spinal cord. These injuries can include a car crash, a fall, a gunshot wound or a sporting injury. Spinal fractures can also be caused by minor injuries if the bones are already weakened due to another condition.

• Spinal stenosis: This is a condition in which the spinal canal gets narrower, compressing the spinal cord. This typically happens in the lower back (lumbar stenosis) or the neck (cervical stenosis). It’s often due to normal wear and tear, and may result as a complication of osteoarthritis, but also can be caused by scoliosis or genetic diseases.

• Hematoma: This is an accumulation of blood. A hematoma around the spinal cord is often caused by injuries, but spinal cord hematomas also can result from abnormal blood vessel formation, bleeding disorders, or medicines that prevent blood clotting. A hematoma can occur suddenly.

• Abscess: An accumulation of pus around the spinal cord can cause compression. This usually develops over a few days or weeks.

• Tumor: This typically occurs when a primary cancer has metastasized and extends from the bone into the epidural space, which is the part of the spinal canal closest to the skin. Sometimes a tumor may form inside the spinal cord, but this is uncommon. Compression from a tumor usually develops over time, either within days or sometimes months.

• Ruptured or herniated disks: A herniated disc more often compresses the spinal nerve roots (spinal nerve compression), but may also put pressure on the spinal cord.

Spinal cord compression risk factors include:

• Conditions that weaken the bones, such as osteoporosis and some cancers

• Spinal arthritis including osteoarthritis and other degenerative forms that can damage the spine

• Certain cancers likely to metastasize to the spine, such as breast cancer, lung cancer, prostate cancer, or kidney cancer

• Spinal deformity

• Bleeding disorders

• Participating in sports or activities with a higher risk of injuring the neck or spine, such as diving into shallow water

You may be able to lower your risk of spinal cord compression by:

• Getting regular physical exercise to strengthen your back muscles and support your spine, especially if you have osteoarthritis of the spine

• Using proper protective gear while participating in high-risk sports or activities

• Protecting your spine by lifting heavy objects properly

If you have a medical condition that increases your chance of spinal cord compression, talk with your doctor about managing that condition. While injuries can be unpredictable, make sure to protect yourself as much as possible, such as wearing a seatbelt when riding in a car.

Treatment of spinal cord compression is often surgery, but an orthopedic or neurosurgeon who specializes in back and spine treatments may recommend other therapeutic medical treatments depending on what’s causing the pressure. If the compression occurs suddenly, surgery must occur as soon as possible to prevent permanent damage to the spinal cord. Spinal cord compression surgery can include removing bone spurs, repairing fractured vertebrae, or stabilizing the spine with rods and screws or fusion.

Treatments include:  

• Emergency surgery to repair a broken spine, which may include removing bone or disc fragments

• Radiation therapy and sometimes surgery to remove a tumor

• Draining of an abscess or hematoma

• Antibiotics to treat an abscess, and sometimes surgery to remove it, depending on the symptoms it’s causing

• Vitamin K injections or plasma transfusion if a hematoma is caused by a bleeding disorder

• Corticosteroid injections to reduce swelling around the spinal cord, often followed by surgery

Without treatment, spinal cord compression can permanently damage the nerves in the spine, which can result in long-term disability. In some cases, spinal cord compression can cause paralysis. The length of time between injury and surgery or other treatment can affect the degree of spinal cord compression and nerve damage.