Spinal cord compression happens more frequently in elderly patients mainly because of age-related changes in the spine that make it more vulnerable to pressure on the spinal cord. As people age, several natural processes and conditions develop that contribute to this increased risk.
One of the primary reasons is **degenerative changes in the spine**, often called spondylosis or spinal osteoarthritis. Over time, the discs between the vertebrae lose height and elasticity, and the facet joints—the small joints that help stabilize the spine—undergo wear and tear. These changes can cause the bones and ligaments around the spinal canal to thicken or enlarge, narrowing the space available for the spinal cord and nerves, a condition known as spinal stenosis. This narrowing increases the likelihood that the spinal cord or nerve roots will be compressed[3][5].
Another major factor is **osteoporosis**, a condition common in older adults where bones become weak and brittle. When the vertebrae lose density, they are more prone to fractures, especially compression fractures. These fractures cause the vertebrae to collapse or shrink, which can deform the spine and reduce the space inside the spinal canal, leading to compression of the spinal cord or nerves. Even minor activities like coughing or twisting can cause fractures in osteoporotic bones, making spinal cord compression more likely[1].
**Degenerative disc disease** also plays a role. The discs that cushion the vertebrae dry out and shrink with age, losing their shock-absorbing ability. This can cause the vertebrae to move closer together, leading to instability and abnormal bone growths called bone spurs. These spurs can protrude into the spinal canal and press on the spinal cord or nerve roots[3].
Additionally, **thickening of ligaments** in the spine, such as the ligamentum flavum, occurs with aging. These ligaments can become stiff and enlarged, further narrowing the spinal canal and contributing to compression[3].
Elderly patients are also more susceptible to **degenerative spondylolisthesis**, where one vertebra slips forward over the one below it due to weakened joints and ligaments. This slippage can pinch the spinal cord or nerves, causing compression[4].
Beyond structural changes, the elderly often experience **loss of muscle mass and physical fitness**, which can reduce spinal support and increase vulnerability to injury or worsening of spinal conditions. Reduced muscle strength and flexibility can also contribute to poor posture, which may exacerbate spinal narrowing and compression[2].
In some cases, **spinal cord compression in older adults is caused by tumors or infections**, which are more common in this age group. These conditions can directly press on the spinal cord or cause swelling that leads to compression[4].
Symptoms of spinal cord compression in elderly patients often include back pain that worsens with movement, stiffness, numbness or weakness in the limbs, and sometimes difficulty walking or controlling bladder and bowel functions. Because these symptoms can develop gradually, they may be mistaken for normal aging or other less serious conditions, delaying diagnosis and treatment.
In summary, spinal cord compression occurs more frequently in elderly patients due to a combination of degenerative spine changes like spondylosis and disc degeneration, osteoporosis-related vertebral fractures, ligament thickening, vertebral slippage, and sometimes tumors or infections. These factors narrow the spinal canal or destabilize the spine, increasing pressure on the spinal cord and nerves. The natural aging process, combined with decreased bone density and muscle strength, creates a perfect environment for spinal cord compression to develop more often in older adults.