Spinal Cord Compression
The spinal cord is the bundle of nerves that runs down the length of your back, delivering messages back and forth between the body and the brain. The spinal cord is protected by the spine, which is composed of 24 bones called vertebrae that are stacked on top of each other and hold the body upright. Spinal cord nerves run through openings between the stacked vertebrae of the spinal column, connecting to surrounding muscles.
Between the vertebrae are intervertebral discs, which are flexible and act like shock absorbers to the back. These disks are flat, round and about a half inch thick. They are made up of annulus fibrosus, which is a tough, but flexible outer ring surrounding the nucleus pulposus, which is a soft, jelly-like center to help cushion impact on the vertebrae.
What is a spinal cord compression injury?
Spinal cord compression occurs when pressure is placed on the spinal cord. This can be caused by a range of different conditions. It can also occur anywhere along the spine – from the neck (cervical spine) down to the lower back (lumbar spine).
Depending on the location of the injury, symptoms of a spinal cord compression can include:
- Pain and stiffness in the affected area
- Burning pain that spreads to the arms, buttocks or down the legs (sciatica)
- Numbness in the arms, hands, legs or feet
- Lack of hand coordination
- Weakness in the foot
- Loss of sexual ability
Pressure on the nerves in the lower back (lumbar spine) can cause cauda equina syndrome, a serious condition that can cause loss of bladder and/or bowel control, numbness in the legs, and pain and weakness in one or both legs that makes it difficult to stand up or walk. Patients experiencing any of symptoms should get medical attention immediately.
What causes spinal cord compression?
Spinal cord compression is often caused by osteoarthritis, where vertebrae are slowly worn down over time. This type of spinal cord compression often occurs gradually, and in patients over 50. It can also be caused by degeneration of the intervertebral disks, which can cause a bone spur or herniated disk.
Due to age, the spinal disks can lose height and begin to bulge. They also lose water and begin to become drier and stiffer. As the disks shrink, the vertebrae move closer together and the body sometimes responds by creating bone spurs to strengthen the bone around the degenerating disk. This can cause further stiffening and compress the spinal cord.
A herniated disk is when the soft center, the nucleus pulposus, pushes against the outer ring (annulus fibrosus). Sometimes, if the ring is worn, the nucleus can bulge through it, into the spinal canal and put pressure on the spinal cord.
Spinal cord compression can also occur more suddenly from conditions or events like:
- Scoliosis (abnormal spine alignment)
- Injury to the spine, like in an automobile accident
- Spinal tumor
- Rheumatoid arthritis
How is a spinal cord compression diagnosed?
Your doctor will discuss your symptoms with you, as well as provide a physical exam to look for loss of sensation, weakness or abnormal reflexes, which can all be signs of spinal cord compression. You will likely be referred for additional diagnostic tests including:
X-rays can show any abnormal alignment of your spine that might be putting pressure on your spinal cord. It can also show bone spurs that could be growing on the vertebrae and causing the compression.
A CT or MRI scan may be recommended as well. These scans can give a more detailed look at the tissues of the spinal cord and the structures around it. A myelogram, a special type of CT scan wherein a contrast dye is injected into the spinal column, can also be used to see the spinal cord and any compression more clearly.