Spinal Cord Compression

What is spinal cord compression?

The spinal cord is a bundle of nerves. It is found in the bones of the spine (vertebrae) and sends messages from the brain to other parts of the body. Spinal cord compression occurs when there is pressure on an area of the spinal cord. This can be caused by cancer cells that have spread to the bones around the spinal cord (vertebrae) or by a tumor in the area of 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?

Bone damage happens when cancer cells spread to the vertebrae. As this new area of cancer grows it can cause swelling in the area or cause the vertebrae to collapse, putting pressure on the spinal cord. This pressure can block blood flow and cause damage to the nerves.

Certain cancers are more likely to spread to the bone than others. The cancers that most commonly 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 the spine. Symptoms can include 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 reduce the chance that the symptoms will become permanent.

The initial treatment often includes corticosteroids (dexamethasone) and/or radiation therapy. Corticosteroids are used to quickly reduce swelling and pressure on the spinal cord. Radiation therapy kills the cancer cells. It can be given in as little as 1-5 doses in many cases. 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 resume or start.

When should I contact 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.
• Numbness.
• 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 you should 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.