Spinal cord compression history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]


Back pain is the most common presenting symptom in almost all acute cases of spinal cord compression. Symptoms of spinal cord compression depends upon the anatomic level involved. All cases of spinal cord compression presents with sensory, motor and autonomic dysfunction. Sensory symptoms include altered sensation below a certain level (e.g., pin, touch, vibration, temperature). Motor symptoms include hemiplegia or hemiparesis (sparing the face), paraplegia or paraparesis, tetraplegia or tetraparesis. Autonomic symptoms include constipation, urinary retention, dizziness (due to hypotension), cold, shivering, and drowsiness (due to hypothermia), erectile dysfunction, abdominal pain and distension (due to ileus), syncope (due to bradycardia).[1][2][3]


The significant information that needs to focus on the history of the patient includes

Common Symptoms

Type of spinal


Cervical Headache

Neck, shoulder or arm pain

Loss of sensation over the upper extremities

Motor weakness of neck, shoulder, and arm

Thoracic Pain in the chest and/or back

Loss of sensation below the level of the compression

Paralysis of respiratory muscles

Lumbosacral Low back pain that may radiate down the legs

Weakness in the legs and feet

Loss of sensation in the legs and feet

Bladder and bowel problems

Sexual dysfunction

Foot drop

Decreased or absent reflexes in the legs

Syndromes Associated with Spinal cord compression

Lesions may develop gradually or acutely and be complete or incomplete. Incomplete lesions often present as distinct syndromes as follows:

Sensory dysfunction Motor dysfunction Sphincter dysfunction
Central cord syndrome Sensory loss is very rare
  • Upper extremity weakness
  • Distal muscles are involved more than proximal
Brown-Séquard syndrome
  • Ipsilateral position and vibration sense loss
  • Contralateral pain and temperature sensation loss
Motor loss ipsilateral to cord lesion -
Anterior cord syndrome
  • Loss of pin and touch sensation
  • Vibration, position sense preserved
Motor loss or weakness below the level of compression -
Transverse cord syndrome Loss of sensation below level of compression Loss of voluntary motor function below the level of compression Loss of urinary sphincter control
Conus medullaris syndrome
  • Sensory loss may range from patchy to complete transverse pattern
  • Peri-anal anaesthesia in conus medullaris syndrome
  • Weakness may be of upper motor neuron type in conus medullaris syndrome.
  • Lower motor neuron symptoms in cauda equina syndrome
Impaired sphincter control
Cauda equina syndrome
Referred pain


  1. 1.0 1.1 Cole JS, Patchell RA (2008). "Metastatic epidural spinal cord compression". Lancet Neurol. 7 (5): 459–66. doi:10.1016/S1474-4422(08)70089-9. PMID 18420159.
  2. 2.0 2.1 Flanagan EP, Pittock SJ (2017). "Diagnosis and management of spinal cord emergencies". Handb Clin Neurol. 140: 319–335. doi:10.1016/B978-0-444-63600-3.00017-9. PMID 28187806.
  3. 3.0 3.1 Ropper, Alexander E.; Longo, Dan L.; Ropper, Allan H. (2017). "Acute Spinal Cord Compression". New England Journal of Medicine. 376 (14): 1358–1369. doi:10.1056/NEJMra1516539. ISSN 0028-4793.

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