26th June 2023

Spinal Cord Compression

A spinal cord compression can be due to a large variety of traumatic and atraumatic causes similar to Cauda Equina and Conus Medullaris syndromes. Traumatic causes include intervertebral disc herniation and compression from vertebral fractures, while atraumatic causes include degenerative spondylosis with resulting myelopathy, spinal epidural abscesses or haematomas, and primary and metastatic spinal cord tumours. A spinal cord compression is a medical emergency, and suspicion should prompt an urgent MRI scan and treatment with urgent glucocorticoids, typically dexamethasone which downregulates vascular endothelial growth factor and prostaglandin E2, decreasing spinal cord oedema. Prompt referral to neurosurgery, and if indicated, oncology teams for rescue radiotherapy should be considered.