What spinal cord compression is
This page tells you about spinal cord compression. There is information about
The spinal cord is a long bundle of nerves which stretches from the brain to the lower part of the back. Nerves extend out from the spinal cord to our limbs, trunk and the organs of our body. These nerves carry messages to and from the central nervous system.
Together the brain and the spinal cord make up the central nervous system. The bones of the spine are called vertebrae and they surround and protect the spinal cord.
The nerves in the neck control movement and feeling in your arms, neck, and shoulders. These nerves are called the cervical nerves.
The nerves in the upper back control the upper part of your chest and your abdomen. These nerves are called the thoracic nerves.
The nerves in the lower back control your legs, bladder, bowel and sexual organs. These nerves are called the lumbar and sacral nerves.
Spinal cord compression happens when there is pressure on the spinal cord. This pressure may be caused by a cancer that started in, or has spread into, the bones of the spine. Between 5 and 10 out of 100 people with cancer (5 to 10%) develop spinal cord compression. Most of these are due to cancer spreading to the spine from another part of the body (metastases). All types of cancer can spread to the bones of the spine. But it is more common in cancers of the prostate, breast or lung, and lymphoma. Your doctor will tell you if you have an increased risk of this happening. Apart from cancer, other causes of spinal cord compression include injury to the spinal cord, weakening of the bones (osteoporosis) and infection.
Pressure on the spinal cord stops the nerves working normally and causes symptoms. The symptoms you have depend on which part of the spinal cord is compressed (squeezed). Spinal cord compression is a serious problem that needs to be treated as soon as possible.
When spinal cord compression is caused by a cancer doctors call it malignant spinal cord compression (MSCC). If it is caused by a cancer that has spread into the spinal bones (secondary cancer) they call it metastatic spinal cord compression.
You are at risk of developing spinal cord compression if you have cancer that
- Has already spread to your bones
- Is at high risk of spreading to the bones, such as breast, lung or prostate cancer
- Started in the spine
The National Institute for Health and Care Excellence (NICE) has produced spinal cord compression guidelines. The guidelines say that your doctor should tell you if you are at risk of spinal cord compression. They should also tell you which symptoms to look out for. It is important for you to know what the symptoms are. You should contact your doctor or specialist nurse straight away if you have any of them. Treating spinal cord compression as soon as possible helps to reduce the risk of permanent damage to the spinal cord.
Symptoms depend on where the pressure is on the spinal cord. The first symptom is usually pain. More than 9 out of 10 people (90%) with spinal cord compression have pain. As the compression gets worse it causes other symptoms. These can mean that some people have difficulty walking, a change in sensation, or problems with their bladder or bowel.
The symptoms to look out for include
- Pain or tenderness in the middle or top of your back or neck
- Severe pain in your lower back that gets worse or doesn’t go away
- Pain in your back that is worse when you cough, sneeze or go to the toilet
- Back pain that stops you from sleeping
- Numbness, weakness or difficulty using your arms or legs
- A band of pain down your arm or leg or around your body
- Changes in sensation in a part of your body, for example pins and needles or electric shock sensations
- Numbness in the area around your back passage (the saddle area)
- Not being able to empty your bowel or bladder
- Problems controlling your bowel or bladder
- Erection problems in men
If you have any symptoms of spinal cord compression contact your doctor or specialist nurse straight away. Don’t wait to see if it gets better and don’t worry if it is an inconvenient time, such as at the weekend or during the night. You need to speak to your doctor or nurse as soon as possible. Explain what your symptoms are and tell them that you are worried you may have spinal cord compression. You should have been given information about who to contact if you have any symptoms.
Your doctor or nurse may want you to go to the hospital straight away for a scan. Your local area should have health professionals who coordinate care for people with spinal cord compression. You may be seen in a hospital that is not your usual hospital.
Your doctor will examine you. If it is possible that you could have spinal cord compression you will have an MRI scan. The scan will show whether you have a cancer affecting the spine. It will also show which part of the spinal cord is compressed. The NICE guidelines recommend that you should have a scan within a week of telling your doctor about your symptoms. But you should have a scan within 24 hours if you have changes in sensation or weakness in your arms or legs.
If you can’t have an MRI scan, you may have other types of scans, such as a CT scan.
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