Spinal Cord Compression
Spinal Cord Compression: At a Glance
What it is: Spinal cord compression occurs when something puts pressure on the spinal cord, affecting how signals travel between the brain and body.
How it affects people: It can cause neck pain, back pain, weakness, numbness, or loss of bladder and bowel control.
Key concern: Untreated compression can lead to permanent spinal cord injury and disability. In some cases, particularly with metastatic spinal cord compression (MSCC), urgent treatment is critical.
Diagnosis: Confirmed with clinical assessment and imaging such as MRI or CT scans.
Treatment options: Pain relief, physical therapy, steroid injections, or surgery depending on severity.
Outlook: With early diagnosis and treatment, many patients recover function and maintain their quality of life.
Spinal cord compression happens when the spinal cord is squeezed by bone, a herniated disc, tumour, or other structures in the spinal column. The compression can reduce blood supply, damage nerve roots, and impair neurological function.
Cancer that spreads to the spine, such as prostate cancer or breast cancer, can also cause compression. This is often referred to as metastatic spinal cord compression (MSCC) and requires urgent medical care.
What is Spinal Cord Compression?
Types of Spinal Cord Compression
Doctors classify spinal cord compression based on where and why the pressure on the spinal cord occurs. Understanding the type helps guide the most effective treatment.
Cervical Spinal Cord Compression: Occurs in the neck (cervical spine) and may cause weakness, numbness, or coordination problems in the arms and legs. It is often due to degenerative changes, disc herniation, or spinal stenosis.
Thoracic Spinal Cord Compression: Affects the mid-back (thoracic spine) and can lead to stiffness, difficulty walking, or balance problems. Causes may include spinal tumours, trauma, or degenerative disease.
Lumbar Spinal Cord Compression: While the spinal cord usually ends in the upper lumbar spine, nerve root compression in this region can cause symptoms similar to sciatica, including leg pain and numbness. It’s often linked to degenerative disc disease or spondylolisthesis.
Acute Spinal Cord Compression: Develops suddenly, usually after trauma, haemorrhage, or spinal infection, and requires emergency treatment to prevent permanent nerve damage.
Chronic Spinal Cord Compression: Progresses slowly over time, often due to arthritis, spinal degeneration, or tumour growth. Symptoms may develop gradually but worsen if untreated.
Spinal Cord Compression Symptoms
Spinal cord compression symptoms depend on the level and severity, but may include:
Back or neck pain
Tingling, numbness, or burning sensations in the arms or legs
Weakness or loss of coordination
Difficulty walking or balancing
Emergency / red flag symptoms
Bladder or bowel incontinence
Doctors advise seeking urgent help if symptoms worsen within 24 hours, as rapid progression can cause permanent damage to the spinal cord.
Causes and Who Is at Risk
Causes of spinal cord compression include:
Herniated disc pressing on the spinal canal
Spinal stenosis (narrowing of the canal)
Degenerative disc disease or arthritis leading to bone spurs
Spinal tumours, including cancers that spread to the spine
Traumatic injury to the vertebrae
Infections affecting the spine
Health and Family Factors You Can’t Change
Ageing, which increases wear and tear on spinal discs and facet joints
Conditions such as osteoporosis or arthritis
Certain types of cancer that spread to the spine
Previous spine surgery or spinal injury
Poor general health that weakens bone or tissue
Reducing Your Risk
While not all cases are preventable, you can reduce the risk by:
Maintaining a healthy weight to reduce strain on the spine
Practising good posture when lifting or sitting
Treating osteoporosis and bone conditions early
Avoiding smoking, which affects bone and disc health
Exercising regularly to keep the spine flexible and strong
Getting a Diagnosis
A diagnosis begins with a full clinical examination to check reflexes, muscle strength, and sensation.
Diagnosis and treatment planning may involve:
MRI scans: The gold standard for visualising compression of the spinal cord and surrounding tissues.
CT scans: Useful for assessing bone changes or fractures.
X-rays: Show spinal alignment, degenerating discs, or abnormal curvature.
Electromyography (EMG): Measures nerve activity and can help confirm pressure on the bundle of nerves within the spinal canal.
Treatment Options for Spinal Cord Compression
Treatment for spinal cord compression depends on the cause, severity, and patient health. Options may include both non-surgical and surgical approaches.
Physical Therapy
Aimed at improving mobility, posture, and muscle strength to reduce strain on the spine and support recovery.
Medication
Pain relief and anti-inflammatory drugs, or short courses of steroids, may help reduce swelling around the spinal cord and relieve discomfort.
Injections
Epidural steroid injections can help manage inflammation and reduce pain in some cases.
Bracing
Supports spinal stability in patients with structural weakness or degenerative conditions.
Spinal Surgery
Procedures such as laminectomy, discectomy, or spinal fusion may be recommended if symptoms are severe, progressive, or associated with neurological deficits. Surgery aims to decompress the spinal cord and preserve long-term function.
Mr Kailaya-Vasan, a consultant neurosurgeon in London, is highly experienced in diagnosing and treating spinal cord compression. Recognised as one of the best neurosurgeons in London for spinal cord compression, he offers both non-surgical care and advanced surgical procedures tailored to each patient.
Living with Spinal Cord Compression
Living with spinal cord compression can be challenging, but most patients improve with timely treatment. Early intervention often prevents lasting neurological deficits and preserves independence.
For patients with MSCC, urgent treatment is vital to prevent long-term disability. Managing cancer-related spinal compression often requires coordination between oncologists, radiologists, and neurosurgeons.
Rehabilitation, including manual therapy and guided exercises, can support recovery after surgery or conservative care. Ongoing medical follow-up ensures long-term stability and helps patients maintain their quality of life.
Book a consultation with Mr Ahilan Kailaya-Vasan
Receive a clear diagnosis and a tailored treatment plan from a leading consultant neurosurgeon. Appointments are available at top London hospitals, with remote options for international patients.
Seeking a second opinion?
If you have already received a diagnosis elsewhere, Mr Kailaya-Vasan can provide an independent review of your scans and medical notes, and explain the safest and most effective next steps.
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It can be caused by a herniated disc, bone spurs, tumours, traumatic injuries, or narrowing of the spinal canal. Some cases result from cancer spreading to the spine, known as metastatic spinal cord compression.
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Severe back or neck pain, numbness, weakness, or difficulty walking may all signal compression. Loss of bladder or bowel control is a red flag requiring urgent medical assessment.
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Treatment ranges from physiotherapy and medications to injections or surgery. In advanced cases, spinal surgery for cord compression relieves pressure on the spinal cord and protects function.
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Emergency spinal cord compression treatment is needed when symptoms appear suddenly, progress rapidly, or involve bladder or bowel control problems.
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A neurosurgeon, such as Mr Ahilan Kailaya-Vasan, is best placed to diagnose and provide both surgical and non-surgical care.
FAQs about Spinal Cord Compression
If you have any further questions, please get in touch.