Myelopathy from Spinal cord compression

Question 1

What is the most common cause of a spinal cord (C1-L2) compression?

Answer 1

Vertebral body neoplasms

Question 2

What cancers may metastasise to the vertebrae?

Answer 2

Prostate
Breast
Kidney (RCC)
Thyroid
Lung

Melanoma

Question 3

Other than vertebral body neoplasms, what causes a spinal cord compression?

Answer 3

Spinal pathology eg, disc prolapse, herniation

Question 4

What are symptoms of myelopathy from a spinal cord compression?

Answer 4

Progressive leg weakness with upper motor neuron signs

(eg. contralateral hyperreflexia, positive Babinski sign, spasticity)

Sensory loss below the lesion
Can have sphincter involvement

Question 5

How do you diagnose myelopathy from spinal cord compression?

Answer 5

MRI spinal cord immediately as risk of permanent spinal cord damage

Chest X-ray if malignancy is suspected

Question 6

How do you treat a spinal cord compression?

Answer 6

Neurosurgery
Laminectomy or microdiscectomy