Spinal Cord Compression
What is spinal cord compression?
Your spinal cord is a group of nerves. It is found in the bones of your spine (vertebrae) and sends messages from your brain to other parts of your body.
Spinal cord compression happens when there is pressure on an area of the spinal cord. This can be caused by cancer cells that have spread to the vertebrae, or by a tumor near the spinal cord.
Spinal cord compression is an oncologic emergency, which is a serious health problem caused by the cancer itself or its treatment. Oncologic emergencies need to be treated right away.
What causes spinal cord compression?
When cancer cells spread to the vertebrae, these bones are damaged. As the cancer grows, it can cause swelling or cause the vertebrae to collapse (cave in), putting pressure on the spinal cord. This pressure can block blood flow and damage the nerves.
Some cancers are more likely to spread to the bone than others. The cancers that most often spread to the bone are prostate, breast, lung, thyroid, multiple myeloma, and kidney.
What are the symptoms of spinal cord compression?
Symptoms can depend on the location of the tumor on your spine. Symptoms may be weakness, trouble walking, pain, and being unable to hold your urine or stool.
How is it treated?
The goal of treatment is to relieve the pressure on the spinal cord. Treatments must begin quickly to lower the chance that the symptoms will become permanent.
The first line of treatment is often corticosteroids (dexamethasone) and/or radiation therapy. Corticosteroids are used to quickly reduce swelling and pressure on your spinal cord. Radiation therapy kills the cancer cells. It can often be given in as little as 1-5 doses.
In some cases, surgery may be used to remove an area of cancer or to stabilize the damaged vertebrae.
Once the compression is treated, treatments for the underlying cancer can begin or start again.
When should I call my care team?
Common signs of spinal cord compression to report to your healthcare provider right away are:
- Any new or worsening back pain. This pain can be in many areas and can radiate (spread) to areas away from the spinal cord. Lying down can often make the pain worse.
- Weakness or a feeling of your legs being "heavy.”
- Trouble walking.
- Loss of bowel or bladder control – this can be incontinence or not being able to urinate or have a bowel movement.
If you are having any signs of cord compression, call your provider right away. If there is a concern for spinal cord compression, they will do a physical and neurological exam. They may also order imaging tests such as a CT scan or MRI.
American Association of Neurological Surgeons. Spinal Tumors. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Tumors
American Academy of Orthopaedic Surgeons. 2022. Cervical Spondylotic Myelopathy: Surgical Treatment Options. Taken from https://orthoinfo.aaos.org/en/treatment/cervical-spondylotic-myelopathysurgical-treatment-options/
MacMillan Cancer Support. Malignant Spinal Cord Compression (MSCC). (2018). https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/malignant-spinal-cord-compression
Robson, P. Metastatic spinal cord compression: a rare but important complication of cancer. Clinical Medicine. (2014). Found at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951968/#:~:text=Metastatic%20spinal%20cord%20compression%20(MSCC,whom%20the%20incidence%20is%2019%25.
Singleton JM, Hefner M. Spinal Cord Compression. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557604/