Spinal Cord Compression

Acute and chronic conditions characterized by external mechanical compression of the SPINAL CORD due to extramedullary neoplasm; EPIDURAL ABSCESS; SPINAL FRACTURES; bony deformities of the vertebral bodies; and other conditions. Clinical manifestations vary with the anatomic site of the lesion and may include localized pain, weakness, sensory loss, incontinence, and impotence.

Also Known As:

Networked: 1791 relevant articles (116 outcomes, 185 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Neoplasms (Cancer)
2.	Neoplasm Metastasis (Metastasis)
3.	Pain (Aches)
4.	Spontaneous Fractures (Pathological Fracture)
5.	Prostatic Neoplasms (Prostate Cancer)

Experts

1.	Rades, Dirk: 60 articles (05/2022 - 10/2002)
2.	Schild, Steven E: 44 articles (05/2022 - 12/2004)
3.	Rudat, Volker: 28 articles (01/2018 - 05/2005)
4.	Veninga, Theo: 27 articles (01/2019 - 05/2005)
5.	Stalpers, Lukas J A: 22 articles (10/2015 - 12/2004)
6.	Hoskin, Peter J: 18 articles (04/2011 - 08/2003)
7.	Karstens, Johann H: 16 articles (08/2014 - 10/2004)
8.	Cacicedo, Jon: 14 articles (05/2022 - 10/2015)
9.	Bilsky, Mark H: 12 articles (01/2021 - 12/2003)
10.	Laufer, Ilya: 12 articles (01/2021 - 09/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Spinal Cord Compression:

1.	Diphosphonates (Bisphosphonates)IBA 01/01/1994 - "This implies that prophylactic bisphosphonates alone would be unlikely to reduce the incidence of spinal cord compression. " 08/30/2003 - "In studies that lasted > or = 6 months, compared with placebo bisphosphonates significantly reduced the odds ratio for fractures (vertebral 0.69, 95% confidence interval 0.57 to 0.84, P < 0.0001; non-vertebral 0.65, 0.54 to 0.79, P < 0.0001; combined 0.65, 0.55 to 0.78, P < 0.0001), radiotherapy (0.67, 0.57 to 0.79, P < 0.0001), and hypercalcaemia (0.54, 0.36 to 0.81, P = 0.003) but not for orthopaedic surgery (0.70, 0.46 to 1.05, P = 0.086) or spinal cord compression (0.71, 0.47 to 1.08, P = 0.113). " 01/01/2010 - "Skeletal-morbidity (spinal cord compression, hypercalcaemia, fracture, need for radiotherapy and surgery to bone) can be effectively reduced by bisphosphonates, a class of anti-resorptive drugs. " 01/01/2004 - "For prevention of skeletal morbidity, bisphosphonates compared with placebo, significantly reduced the OR for fractures (OR [95% CI], vertebral, 0.69 [0.57-0.84], non-vertebral, 0.65 [0.54-0.79], combined, 0.65 [0.55-0.78]) radiotherapy 0.67 [0.57-0.79] and hypercalcaemia 0.54 [0.36-0.81] but not orthopaedic surgery 0.70 [0.46-1.05] or spinal cord compression 0.71 [0.47-1.08]. " 08/30/2003 - "In people with metastatic bone disease bisphosphonates significantly decrease skeletal morbidity, except for spinal cord compression and increased time to first skeletal related event. "
2.	Cisplatin (Platino)FDA LinkGeneric 02/01/1998 - "Specific causes for Lhermitte's sign (LS) in cancer patients are spinal cord compression, radiation therapy to the spinal cord, and cisplatin chemotherapy. " 06/01/1998 - "A 44-year-old man with bulky Stage II classic seminoma obtained complete remission with four cycles of cisplatin etoposide combination chemotherapy, but relapsed with lumbar vertebral metastases with epidural spinal cord compression 5 months after completion of primary treatment. " 01/01/2021 - "Spinal cord compression at thoracic-12 level from SCCT was successfully relieved with neurosurgical treatment, chemotherapy with etoposide and cisplatin, and radiotherapy, while gefitinib treatment was maintained. " 06/01/2014 - "However, after palliative radiotherapy to thoraco-lumbar spine for spinal cord compression, and adding chemotherapy (six cycles of EDP: etoposide, doxorubicin, cisplatin) to mitotane, a significant partial remission was achieved. "
3.	Etoposide (VP 16)FDA LinkGeneric 06/01/1998 - "A 44-year-old man with bulky Stage II classic seminoma obtained complete remission with four cycles of cisplatin etoposide combination chemotherapy, but relapsed with lumbar vertebral metastases with epidural spinal cord compression 5 months after completion of primary treatment. " 01/01/2021 - "Spinal cord compression at thoracic-12 level from SCCT was successfully relieved with neurosurgical treatment, chemotherapy with etoposide and cisplatin, and radiotherapy, while gefitinib treatment was maintained. " 06/01/2014 - "However, after palliative radiotherapy to thoraco-lumbar spine for spinal cord compression, and adding chemotherapy (six cycles of EDP: etoposide, doxorubicin, cisplatin) to mitotane, a significant partial remission was achieved. "
4.	Dexamethasone (Maxidex)FDA LinkGeneric 06/01/1989 - "This study supports the use of highdose dexamethasone for the initial treatment of epidural spinal cord compression." 06/01/2016 - "Her compressive myelopathy was treated with pulses of high dose dexamethasone. " 05/01/2013 - ""Vanishing" spinal cord compression in myeloma: dramatic and rapid response to dexamethasone monotherapy." 12/01/2006 - "Epidural spinal cord compression can be treated with dexamethasone, radiation, or surgery. " 04/01/2005 - "Early use of dexamethasone in malignant spinal-cord compression: a missed opportunity?"
5.	Zoledronic Acid (Zometa)FDA Link 10/01/2012 - "In contrast to other studies, this matched-pair analysis focused solely on the impact of zoledronic acid on metastatic spinal cord compression (MSCC). " 08/01/2022 - "Spinal Paget's disease with bilevel cord compression and ischemic non-compressive myelopathy treated with zoledronic acid." 10/01/2012 - "Impact of zoledronic acid on control of metastatic spinal cord compression." 10/01/2021 - "Zoledronic acid (ZA) or DEN reduces skeletal metastases complications, including pathological fracture, spinal cord compression, or the necessity for radiation or surgery to bone. " 02/01/2018 - "zoledronic acid) are approved in Europe for the prevention of skeletal-related events (pathologic fracture, radiation or surgery to bone, and spinal cord compression) in adults with bone metastases secondary to solid tumours. "
6.	DenosumabFDA Link 09/01/2022 - "Three months after the re-administration of denosumab, CT showed recalcification and recovery of upper extremity muscle strength, and MRI revealed improvement in spinal cord compression." 06/01/2016 - "In association with denosumab, an osteosynthesis was added in case of vertebral fracture and a laminectomy in case of spinal cord compression. " 09/01/2020 - "When spinal cord compressions were grouped by tumor origin (endodermal or mesodermal), there remained no significant difference between denosumab and ZA. " 09/01/2020 - "Denosumab does not significantly reduce the likelihood of spinal cord compressions in comparison to ZA in patients with spine metastases. " 09/01/2020 - "Denosumab was not significantly superior to ZA in reducing the likelihood of spinal cord compression, when all tumor types were combined (odds ratio [OR] 0.92, 95% confidence interval [CI; 0.66, 1.28], P = .66). "
7.	Glial Cell Line-Derived Neurotrophic Factor (GDNF)IBA 06/01/2008 - "The aim of present study was to examine whether systemically delivered glial cell-derived neurotrophic factor (GDNF) was beneficial in reversing the spinal cord injury (SCI) in a spinal cord compression model. " 06/01/2008 - "The results indicate that GDNF treatment may be beneficial in reversing hind limb dysfunction by reducing spinal cord infarction and apoptosis in a spinal cord compression model." 01/01/2008 - "The results indicate that CD34(+) cell therapy may be beneficial in reversing the SCI-induced spinal cord infarction and apoptosis and hindlimb dysfunction by stimulating the production of both VEGF and GDNF in a spinal cord compression model."
8.	Adrenal Cortex Hormones (Corticosteroids)IBA 03/01/2022 - "Patients presenting with neurological deficit secondary to metastatic epidural spinal cord compression (MESCC) are often treated with surgery in combination with high-dose corticosteroids. " 03/19/2020 - "Multiple reviews have attempted to describe the ideal regimen of corticosteroids for metastatic spinal cord compression, but there is little consensus. " 05/01/2017 - "Corticosteroid Treatment for Metastatic Spinal Cord Compression: A Review." 03/01/2014 - "We describe a rare cause of spinal cord compression in a 29-year-old man resulting from a complication of long-term corticosteroid use. " 08/10/2008 - "When spinal cord compression is suspected, providers should treat with corticosteroids and evaluate with whole-spine magnetic resonance imaging scan or myelography as soon as possible but within 24 hours. "
9.	SteroidsIBA 07/01/2023 - "There are not enough high-quality studies on the use of steroids for metastatic spinal cord compression." 01/01/2019 - "Steroid administration is part of a standard treatment regimen in metastatic spinal cord compression, though the appropriate dose, duration, efficacy, and risks remain controversial. " 01/01/2017 - "Metastatic Spinal Cord Compression and Steroid Treatment: A Systematic Review." 01/01/2012 - "Conus medullaris syndrome after epidural steroid injection: Case report." 05/01/2009 - "Clinicians who plan an epidural steroid injection must perform a rigorous evaluation through a detailed physical examination, simple laboratory tests, and history taking to prevent various risks associated with spinal cord compression."
10.	Cholecalciferol (Vitamin D3)FDA Link 11/01/2015 - "In a previous study, based on a rat model of thoracic spinal cord compression, we demonstrated that cholecalciferol (Vitamin D3), delivered at the dose of 200 IU/kg/day, significantly improved ventilatory frequency and spasticity. " 01/01/2014 - "In a first study, using a rat model of spinal cord compression at the T10 thoracic level, we delivered vitamin D3 (cholecalciferol) orally at the dose of 50 IU/kg/day or 200 IU/kg/day. "

Therapies and Procedures

1.	Radiotherapy 05/01/1995 - "Radiotherapy is effective for most cases of spinal cord compression. " 12/01/2013 - "In 2005, a Landmark study showed that direct decompressive surgery, followed by postoperative external beam radiotherapy (EBRT) is superior to EBRT alone in patients with metastatic epidural spinal cord compression (MESCC). " 11/01/2009 - "8Gy single-dose radiotherapy is effective in metastatic spinal cord compression: results of a phase III randomized multicentre Italian trial." 02/28/2022 - "In 2005, a randomized trial showed that addition of surgery to radiotherapy improved outcomes in patients with metastatic spinal cord compression (MSCC). " 10/01/2015 - "In this study, we evaluate the efficacy of short-course radiotherapy (SCRT) versus long-course radiotherapy (LCRT) in the treatment of metastatic spinal cord compression (MSCC).PubMed, EMBASE, and Web of Science were searched up to April 2015. "
2.	Therapeutics 04/01/2015 - "Following primary therapy, the symptoms of spinal cord compression were relieved. " 09/01/1999 - "Intravascular lymphomatosis presenting as an ascending cauda equina: conus medullaris syndrome: remission after biweekly CHOP therapy." 02/01/1993 - "Two of 5 patients (40%) with spinal cord compression showed improvement following therapy by regaining the ability to walk, while none of the remaining patients had further acute deterioration of neurologic function. " 09/02/2015 - "There have been few studies of the outcomes or prognostic factors in patients with metastatic spinal cord compression from NSCLC treated with surgery and adjuvant therapies. " 07/03/2019 - "There is no medical therapy for this disease, and surgery is reserved for patients with CM caused by spinal cord compression. "
3.	Laminectomy 01/01/2018 - "Cervical laminectomy is an effective treatment for multilevel cervical compressive myelopathy. " 01/01/2018 - "Our experience indicates ultrasonic devices are safe and effective for laminectomy treating multilevel and severe compressive myelopathy, the instrument could be used with ease especially for cases with ossified posterior longitudinal ligament and ossification of the ligamentum flavum, proper utility of the instrument is crucial to prevent complications." 01/01/2021 - "Thoracic OLF and AS rarely contribute T9-T10 spinal cord compression that may be readily relieved with a decompressive laminectomy." 07/01/2023 - "This study aimed to describe the clinical outcome of metastatic epidural spinal cord compression in octogenarians with an acute onset of neurological illness who undergo laminectomy, further assess morbidity and mortality rates, and determine potential risk factors for a nonambulatory outcome. " 04/01/2023 - "The aim of the study was to investigate the postoperative ambulatory status of neurologically impaired metastatic spinal cord compression (MSCC) patients who underwent laminectomy and evaluate predictors of postoperative ambulation recovery after laminectomy for MSCC. "
4.	Decompression 03/01/2015 - "Compared with posterior decompression, anterior decompression improved spinal cord function better and relived spinal cord compression more effectively with a more reasonable mechanics of internal fixation. " 01/01/2020 - "Anterior decompression was appropriate for patients with localized spinal cord compression by a large OPLL in the kyphotic curve, and CDF via a posterolateral approach appears to be safe and effective. " 01/01/2023 - "The study examined the efficacy of decompression surgery for patients with metastatic cervical spine lesions contributing to spinal cord compression. " 11/01/2011 - "Efficacy of decompression and fixation for metastatic spinal cord compression: analysis of factors prognostic for survival and postoperative ambulation." 01/01/2022 - "From January 2020 to January 2021, patients with spinal cord compression symptoms and imaging-defined single-level thoracic OLF were enrolled in this study and received UBE decompression treatment. "
5.	Drug Therapy (Chemotherapy) 05/01/2008 - "Rapid initiation of chemotherapy was safe and effective in a neonate with NBL complicated by spinal cord compression." 10/01/2019 - "The objective of this study is to report a primary thoracic dumb-bell YST presenting with severe spinal cord compression successfully treated with posterior-only approach operation, followed by chemotherapy. " 03/01/2019 - "However, patients who are non-ambulatory due to metastatic epidural spinal cord compression (MESCC) may be assessed as unable to tolerate chemotherapy secondary to poor performance status. " 02/01/2015 - "Spinal cord compression in NB can be effectively managed with upfront chemotherapy. " 01/01/2015 - "Local chemotherapy is effective and minimally invasive for patients with severe local symptoms without spinal cord compression. "