Adult Medical-Surgical Nursing

1
Adult Medical-Surgical Nursing

• Neurology Module
• Spinal Cord Compression

2
Spinal Cord Compression Definition

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

3
Spinal Cord Compression Description

• Spinal cord compression is related to
• Lymphoma
• Intervertebral collapse
• A tumour (most often a metastatic tumour from a
  primary breast, lung, kidney or prostate cancer,
  lymphoma or myeloma)
• Metastatic tumours cause bone erosion and spinal
  cord compression

4
Spinal Cord CompressionSites of Occurrence

• Spinal cord compression occurs
• 70 in the thoracic region
• 20 lumbar-sacral
• 10 cervical

5
Spinal Cord Compression Clinical Manifestations

• Pain in the affected area or tracking down the
  spinal canal
• Numbness in extremities (? sensation)
• Impaired motor function ? flaccid paralysis
• Bladder and bowel dysfunction (incontinence)

6
Spinal Cord Compression Diagnosis

• Patient history and clinical picture
• MRI
• CT scan
• Myelogram
• Bone scan
• Xrays spinal cord
• Investigations for primary tumour if suspected

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Spinal Cord CompressionMedical Management

• Radiation reduces the tumour size
• Steroid therapy reduces inflammation
• Chemotherapy
• Surgery
• The patient may have residual neurological
  impairment following treatment

8
Spinal Cord Compression Nursing Considerations

• Pain relief and close support
• Prevention of complications of immobility
• Deep venous thrombosis
• Pressure ulcers
• Chest infection
• Urinary stasis/ infection
• Maintain muscle tone and joint mobility
• Bladder/ bowel training

9
Spinal Cord Compression Family Support

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