| Spinal Cord Compression |
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Symptoms suggestive of cord compression are Back Pain , a Dermatome of increased sensation, Paralysis of limbs below the level of compression, decreased sensation below the level of compression, Urinary and Fecal Incontinence and/or Urinary Retention . Lhermitte's Sign (intermittent shooting electrical sensation) and Hyperreflexia may be present. Diagnosis is by X-ray s but preferably Magnetic Resonance Imaging (MRI) of the whole spine. The most common causes of cord compression are tumors, but Abscess es and Granuloma s (e.g. in Tuberculosis ) are equally capable if producing the syndrome. Tumors that commonly cause cord compression are Lung Cancer (non-small cell type), Breast Cancer , Prostate Cancer , Renal Cell Carcinoma , Thyroid Cancer , Lymphoma and Multiple Myeloma . Dexamethasone (a potent Glucocorticoid ) in doses of 16 mg/day may reduce Edema around the lesion and protect the cord from injury. It may be given Intravenous ly for this indication. Surgery is indicated in localised compression as long as there is some hope of regaining function. It is also occasionally indicated in patients with little hope of regaining function but with uncontrolled pain. Radiation Therapy (usually 40 Gray in 5-8 fractions) is very effective as pain control, but is similarly ineffective to restore function once the symptoms are advanced. SOURCE
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