Post on 04-Jan-2016
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