Adult Medical-Surgical Nursing Neurology Module: Spinal Cord Compression.

Adult Medical-Surgical Adult Medical-Surgical Nursing Nursing

Neurology Module:Neurology Module:

Spinal Cord CompressionSpinal Cord Compression

Spinal Cord Compression: Spinal Cord Compression: DefinitionDefinition

Pressure on the spinal cord which may Pressure on the spinal cord which may lead to permanent neurological impairmentlead to permanent neurological impairment

Spinal Cord Compression: Spinal Cord Compression: DescriptionDescription

Spinal cord compression is related to:Spinal cord compression is related to:

LymphomaLymphoma

Intervertebral collapseIntervertebral collapse

*A tumour (most often a metastatic tumour *A tumour (most often a metastatic tumour from a primary breast, lung, kidney or from a primary breast, lung, kidney or prostate cancer, lymphoma or myeloma)prostate cancer, lymphoma or myeloma)

Metastatic tumours cause bone erosion Metastatic tumours cause bone erosion and spinal cord compressionand spinal cord compression

Spinal Cord Compression:Spinal Cord Compression:Sites of OccurrenceSites of Occurrence

Spinal cord compression occurs:Spinal cord compression occurs:

70% in the thoracic region70% in the thoracic region

20% lumbar-sacral20% lumbar-sacral

10% cervical10% cervical

Spinal Cord Compression: Spinal Cord Compression: Clinical ManifestationsClinical Manifestations

Pain in the affected area or tracking down Pain in the affected area or tracking down the spinal canalthe spinal canal

Numbness in extremities (↓ sensation)Numbness in extremities (↓ sensation)

Impaired motor function → flaccid Impaired motor function → flaccid paralysisparalysis

Bladder and bowel dysfunction Bladder and bowel dysfunction (incontinence)(incontinence)

Spinal Cord Compression: Spinal Cord Compression: DiagnosisDiagnosis

Patient history and clinical picturePatient history and clinical pictureMRIMRICT scanCT scanMyelogramMyelogramBone scanBone scanXrays spinal cordXrays spinal cordInvestigations for primary tumour if Investigations for primary tumour if suspectedsuspected

Spinal Cord Compression:Spinal Cord Compression:Medical ManagementMedical Management

Radiation reduces the tumour size Radiation reduces the tumour size

Steroid therapy reduces inflammationSteroid therapy reduces inflammation

ChemotherapyChemotherapy

SurgerySurgery

The patient may have residual The patient may have residual neurological impairment following neurological impairment following treatmenttreatment

Spinal Cord Compression: Spinal Cord Compression: Nursing ConsiderationsNursing Considerations

Pain relief and close supportPain relief and close supportPrevention of complications of immobility:Prevention of complications of immobility:Deep venous thrombosisDeep venous thrombosisPressure ulcersPressure ulcersChest infectionChest infectionUrinary stasis/ infectionUrinary stasis/ infectionMaintain muscle tone and joint mobilityMaintain muscle tone and joint mobilityBladder/ bowel training Bladder/ bowel training

Spinal Cord Compression: Spinal Cord Compression: Family SupportFamily Support

Emotional support to patient and family to Emotional support to patient and family to assist coping with all aspects of what may assist coping with all aspects of what may be a progressive condition with a poor be a progressive condition with a poor prognosisprognosis