Spinal cord compression natural history, complications and prognosis

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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]

Overview

Spinal cord compression is an emergency condition that needs immediate treatment. If left untreated it leads to permanent damage to nerve roots and paralysis. Complications that can develop as a result of spinal cord compression include pressure ulcers, deep vein thrombosis, urinary tract infections, MRSA infection, pulmonary embolism. Prognosis is poor if the syndrome is complete (quadriparesis and with no sensory preservation), and recovery is less than 5%. The mortality rate for 1 year after injury in patients with complete lesions can be 100%. On the contrary, the prognosis is much better for the incomplete cord syndromes with some preserved sensory function with recovery rate greater than 50%.[1][2][3][4]

Natural History

Spinal cord compression is an emergency condition that needs immediate treatment. If left untreated it leads to permanent damage to nerve roots and paralysis.

Complications

Complications that can develop as a result of spinal cord compression include:

Prognosis

  • The factors that determine the prognosis of an acute spinal cord compression depends upon
    • Type of compression
    • Degree of paralysis
    • Sensory preservation
    • Time of presentation
  • Prognosis is poor if the syndrome is complete (quadriparesis and with no sensory preservation), and recovery is less than 5%.
  • The mortality rate 1 year after injury in patients with complete lesions can be 100%.
  • On the contrary, the prognosis is much better for the incomplete cord syndromes with some preserved sensory function with recovery rate greater than 50%.[1][2][3][4]

References

  1. 1.0 1.1 Findlay GF (1984). "Adverse effects of the management of malignant spinal cord compression". J. Neurol. Neurosurg. Psychiatr. 47 (8): 761–8. PMC 1027935. PMID 6470717.
  2. 2.0 2.1 Bach F, Larsen BH, Rohde K, Børgesen SE, Gjerris F, Bøge-Rasmussen T, Agerlin N, Rasmusson B, Stjernholm P, Sørensen PS (1990). "Metastatic spinal cord compression. Occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression". Acta Neurochir (Wien). 107 (1–2): 37–43. PMID 2096606.
  3. 3.0 3.1 Suk KS, Lee HM, Moon SH, Kim NH (2001). "Recurrent lumbar disc herniation: results of operative management". Spine. 26 (6): 672–6. PMID 11246384.
  4. 4.0 4.1 Darouiche RO (2006). "Spinal epidural abscess". N. Engl. J. Med. 355 (19): 2012–20. doi:10.1056/NEJMra055111. PMID 17093252.

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