Spine surgery encompasses many aspects of patient mobility, but none as serious as spinal cord injury. Injury to the spinal cord can happen from an accident where the bones get violently moved out of position and pinch the spinal cord. This may just be an instant compression on impact than released or a sustained compression that continues if the bones do not snap back to their normal position again. Spinal cord injury related to an accident has a quick onset and patients know right away that there is a problem with their nerves.
A more commonly seen and slowly developing spinal cord injury is related to arthritis. Spine surgeons call this degenerative cervical myelopathy. As the discs in the neck deteriorate, they will begin to bulge and compress the spinal cord. This takes many years and most patients don’t feel the effects of this compression until they realized they are losing their balance. There may be a simple injury or jolt that is able to push this compression over the edge, but most patients don’t recognize the subtle changes from the compression. They may think they are getting slower as they age, don’t have the same reflexes they used to have and their balance is getting worse due to the aging process. It may take a family member to intervene when the patient begins to need more assistance in daily life. They may not be able to button their clothes, hold small objects like coins, or not be able to write legibly anymore. Needing to use a cane or walker is common as we get older, but falling is not a sign of aging. These subtle early signs of spinal cord compression are the reason to seek medical help.
Spinal cord compression is best treated surgically. Unfortunately, there is no good way to relieve compression on the spinal cord without surgery. However, a recently published study from Germany (Spine Vol 46:5) has found that those patients that are treated early in the process have a much higher chance of getting back to normal than those who delay treatment. As the spinal cord gets more compressed, the nerves will begin to swell and cause worsening of the symptoms. This study found that those patients with swelling in the spinal cord from disc compression were less likely to have a full recovery of the neurologic function. They also found that the older patients with spinal cord compression did not do as well as the younger patients, which makes sense in almost all aspects of medicine.
Surgery for spinal cord compression should be done by a fellowship-trained spine surgeon who will be able to decompress the spinal cord and stabilize the bones to prevent any further damage. Most of these surgeries are done on an outpatient basis depending on how debilitated the patient is prior to surgery. The patients with more neurologic dysfunction including those using a wheelchair prior to surgery, will have the hardest time recovering after surgery. They will need significant therapy after surgery to regain their independent walking ability. If you are noticing these signs of neurologic changes, seek medical advice as it will be easier to recover from spinal compression earlier in the disease process.
Make an appointment with Dr. Carlson or another OSC provider by clicking the “Request Appointment” button below or by calling (757) 596-1900.