r/t loss of rectal sphincter co Spinal cord

compression
Introduction; spinal cord compression is pressure on the spinal cord in
which symptoms can occur to indicate cord compression like numbness
weakness in arms or legs . Pressure on the spinal cord causes the nerves in
the spinal cord to swell and slows down or blocks their blood supply.It
may be compressed by hematomas ,pus abscesses, tumors (cancerous or not)
or a ruptured or herniated disk it leads impaired function of spinal cord.
Definition; SCC is a form myelopathy in which scc causes can be bone
fragments from vertebral fracture a tumor abscess ,ruptured intervertebral
disc or other lesion.
Causes /etiology
1) The most common cause is tumors
2) Abscesses and granulomas e g in tuberculosis these are equally
capable of producing syndrome.
3) lung cancer (non cell type breast ca prostate ca and renal cell
carcinoma thyroid ca .
4) lymphoma and multiple myeloma
5) Abnormal spine alignment (scoliosis)
6) Injury to spine (wether traumatic or accidental)
7) Certain bone disease like Rheumatid arthritis osteioarthrities etc
8) Infection

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Pathophysiology of spinal cord compression
Mechanism of cord compression
Enlarging vertebral mass
Compress the spinal vasculature
Pressure over the thecal sac and spinal nerves
Severe pain and neurologic deficits occur
Destruction of vertebral body due to
Interruption of blood flow leads hypoxia
Ischemia and infraction occur

Signs and symptoms of SCC

1) pain and stiffness in the neck back or lower part of the body
2) Burning pain that spreads to the arms buttocks or down into
the legs (sciatica)
3) Numbness cramping or weakness in the arms hands or legs
4) Loss of sensation in the feet
5) Trouble with hand or leg coordination
6) Foot drop weakness in a foot that causes a limp 7) Loss of
sexual ability 8) Loss of bowel and bladder control 9) sever or
increasing numbness between the legs and inner thighs and back

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of the legs 10) Sever pain and weakness that spreads into one or
both legs making it hard to walk or get out of a chair
11) Dermatome of increased sensation paralysis of limbs below the
level of cord compression
12) Urinary and fecal incontinence or urinary retention
13) Lhermitte,s sign (intermittent shooting and electrical
sensation)
Diagnostic evaluvation;
1) X-ray spine this shows bone growth and abnormal alignment of
spine
2) Special imaging test like CT and MRI will give more detailed
look at structure surrounding it
3) Other studies like bone scan special x-ray or ct scan myelogram
and electromyography ( it an electrical test of muscle activity)
Management of SCC
The medical team involved in treating SCC may
include arthritis specialists bone surgeons nerve specialists and
physical therapists. The treatment depends on cause and symptoms
of scc . It may involve medicines physical therapy injections and
surgeries except in cases of emergency. 1) Medicines may include
NSAIDS that relive pain and swelling ,and steroid injections

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2)IN acute scc cases high doses steroids are used to save nerve cells
until other treatment can be started
3) Physical therapy may include exercises to strengthen back
abdominal and muscles and safty braces like cervical collar back
supporting belt etc
4) Surgical treatments include removing bone squrs and making the
space between vertebrae wider etc
5) Other treatment like acupuncture acupressure etc

Nursing Management for case of scc

1) Ensure airway, breathing ,and circulation stability
2) Prevent complications such as pressure sores uti infections and
respiratory infections
3) provide pain management and optimize comfort
4) Facilitate rehabilitation and mobility interventions and to maximize
independence
5) Address psychosocial needs and promote emotional well-being
6) Educate the client about self care adaptive techniques and prevention
of secondary complications 7) Coordinate interdisciplinary care and
facilitate a smooth transition to home or supportive care setting.
Nursing diagnosis;

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1) Ineffective airway clearance r/t paralysis of respiratory , chest and
abdominal muscle.
2) Acute pain r/t irrited nerve root and soft tissue injury
3) Impaired physical mobility r/t loss of motor function
4) Risk for impaired skin integrity r/t immobilization and loss of bladder
and control5) Bowel incontinence ntrol

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