Clinical Features of Spinal Compression

Abstract

The term “spinal cord compression” is widely used in clinical practice to indicate the pathological and clinical entity caused by an expanding lesion within the spinal canal. There are a great number of causes of compression (Table 10.1). The pressure effect could be on the spinal cord and/or the nerve roots emerging from the cord. A rapidly expanding lesion will cause an “acute” clinical presentation whereas the symptoms of a slow-growing benign tumour will evolve over a much longer period. Occasionally, “chronic” compression can lead to an acute course usually due to sudden rapid expansion or ischaemia from vascular occlusion. The neurological features are determined by the rate of expansion of the lesion and the spinal level involved. Careful neurological assessment will localize the anatomical site of compression. There are well recognized patterns or “syndromes” of clinical presentation. Certain diseases display symptoms and signs due to involvement of other systems. Early diagnosis results in a better prognosis and functional outcome. This can be achieved by combining good clinical knowledge with careful assessment of patients followed by appropriate investigations.