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
Once complete paralysis has been present for more than about 24 hours before treatment, the chances of useful recovery are greatly diminished, although slow recovery, sometimes months after radiotherapy, is well recognised. The median survival of patients with metastatic spinal cord compression is about 12 weeks, reflecting the generally advanced nature of the underlying malignant disease.
Natural History
Spinal cord compression is a 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:
- Pressure ulcers
- Deep vein thrombosis
- Urinary tract infections
- MRSA infection
- Pulmonary embolism
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 its complete, quadriparesis and with no sensory preservation. Recovery is <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. Recovery is >50%.