Pathophysiology

The spinal cord emerges from the brain stem at the base of the skull and terminates at the second lumbar vertebra. The thoracic spine is most vulnerable to cord compression because of natural kyphosis and because the width of the thoracic spinal canal is the smallest among the vertebrae. Most spinal cord compression is due to adjacent vertebral metastases that compress the spinal cord or from pathologic compression fracture of the vertebra. This results in significant edema and inflammation in the affected area.

Patients with spinal cord compression are in acute, severe back and/or neck pain and may present to the emergency department for evaluation. Diagnosis is made based on symptoms and imaging studies that show fractured vertebrae.

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