The spinal column is made up of a number of vertebrae that are divided into the cervical, thoracic and lumbar regions of the spine. The cervical spine has 7 vertebrae. The thoracic spine has 12 vertebrae and the lumbar spine 5 vertebrae. At the bottom of the spine is a triangle collection of bones called the sacrum and at the tip of the sacrum is the coccyx or tailbone. The primary function of the spinal column is to protect the spinal cord. The spinal cord runs from the base of the brain through a large hole called the foramen magnum (large hole in Latin) down the center of the spinal column. At each spinal level exits a spinal nerve, which travels from the spinal cord through “another hole” called the intervertebral foramen (hole in between vertebrae) out into the body. Typically, the spinal cord ends at the L1-L2 levels and then has a number of nerves hanging down towards the sacrum, which is called the cauda equina (Latin for horse's tail).
Frequency of Spinal Cord Compression
It is reported that every year there are approximately 12,000 new cases of spinal cord compression. Spinal cord compression can be caused by trauma (such as auto accidents, falls, sports injury, epidural injection, facet joint injection), space occupying lesions (infection, tumor, hematoma), and ruptured, slipped, protruded or herniated discs.
Symptoms of Spinal Cord Compression
The symptoms of spinal cord compression can include:
- Loss of the ability to move arms or legs (motor paralysis)
- Loss of feeling (sensory paralysis) – sciatica
- Loss of bladder or bowel control (incontinence)
If any of these symptoms come on quickly, it is a medical emergency and you need to be seen by a healthcare provider ASAP. The longer the spinal cord is compressed – the smaller the chance of a full recovery.
Diagnosis of Spinal Cord Compression
Healthcare providers utilize a number of procedures to diagnose spinal cord compression. Initially, the doctor must do a complete examination. If there is frank spinal cord compression, the patient will show a pattern of weakness, loss of sensation, reflex changes and possibility pathological reflexes consistent with the level of the spinal cord that is injured. If there is nerve root compression, the patient's clinical presentation will have findings consistent with the specific nerve root(s) injured.
Additionally, diagnostic imaging studies such as x-ray, computerized tomography (CT) and magnetic resonance imaging (MRI) help diagnose spinal cord compression. MRI is the best test to diagnose spinal cord or nerve root compression because the spinal cord and nerves are visualized in the test.
Causes of Spinal Cord Compression
Spinal cord compression can be caused by automobile accidents, truck accidents, motorcycle accidents and falls. A fracture of the vertebrae can compress the spinal cord. Also, the intervertebral disc can be herniated or extruded and a piece can actually hit the spinal cord. If these conditions aren't diagnosed and treated timely and accurately patients can suffer serious consequences including death, paralysis or loss of bladder and bowel function. If a healthcare provider drops the ball and fails to timely diagnose spinal cord compression, the victim may have a medical malpractice claim.
Spinal cord injuries are complex and can arise from a variety of situations. It is best under these circumstances to retain an attorney who has sufficient medical knowledge to be a strong advocate for the client.