Spinal Cord Compression

Spinal Cord Compression Notes
Physiology and anatomy
-          The spinal cord runs from C1 (junction with the medulla), to about L1, where it becomes the cauda equina.
o   Note that it terminates lower down in children – the spinal cord cannot grow as well as the rest of the body!
-          The spinal cord gets its blood supply mainly from the vertebral arteries.

Spinal Cord Compression

Spinal Cord Compression
Clinical features
-          Spastic paraparesis / tetraparesis
-          Radicular pain at the level of the compression
-          Sensory loss below the level of the compression
-          Degenerative disc lesions, e.g. Herniated disc
-          Degenerative vertebral lesions, e.g. Osteoporosis
-          TB
o   The most common cause of spinal cord compression in countries where TB is common
o   There is destruction of both the disc and the vertebra
o   Paralysis can occur – in which case it is called Pott’s Paraplegia
-          Epidural abscess
-          Vertebral neoplasms:
o   Myeloma
o   Metastasis
§ Bone, Bronchus, Prostate, Lymphoma, Thyroid
o   Menningioma
o   Neurofibroma
o   Ependymoma
o   Glioma
o   Lipoma
o   Teratoma
o   Symptoms will occur gradually over months, perhaps even years with slow growing tumours (e.g. glioma). There will usually be root pain and an obvious sensory level.
-          Epidural haemorrhage
-          Paget’s disease
-          Spinal cord compression at T4
o   Pain radiates around the thorax, typically worse on coughing
o   Spastic paraparesis develops slowly of the following hours days or weeks depending on the underlying pathology
o   Numbness from the feet to the level affected
o   Urinary Retention
o   Constipation

-          It is a medical emergency
-          Can be difficult to differentiate a chronic from an acute cause, particularly if pain and sensory level are ambiguous.
Notes by Tom Leach

Artikel Terkait

Next Post »