Spinal chord compression Flashcards
Define Spinal Cord Compression
SCC RESULTS from other issues causing compression or displacement of the arteries, venous, CSF or cord itelf within the spinal cord
can result of extrinsic causes/lesions (trauma, disc disease) or intrinsic ones (cancer, vascular aetiologies)
Aetiology and risk factors of Spinal Cord Compression
Numerous causes that cause a compression/displacement of the arteries, veins, CSF or cord within the cord
trauma is associated with younger pops:
Falls, car accidents, knife, surgery, gunshot
Vertebral compression fractures; in older people with weaker bones:
Osteoporosis, corticosteroids, osteomalacia, myelitis, tumour infilrtation
Disc disease-herniation of nucleus pulposus through annulus fibrosis-press on roots or on cord (unilateral or bilateral)
Tumours-older patients-sarcoma, myeloma, CNS tumours,
metastasis from: Renal cancer, lung cancer, breast cancer, prostate cancer
infection-discitis, tuberculosis, assess
risk factors-signs of any of these,
IV drug use
manual handling work
Immunosupression
Epidiemology of Spinal Cord Compression
very common in general
trauma is main cause of acute SCC –under 65
in older, main causes are osteoporosis+fracture
2% of US has sciatica
Signs and symptoms of Spinal Cord Compression
Acute onset-trauma, herniation
Chronic-fractures, malignancies
key: Back pain (not always with neurological signs)
Sensory changes-
Sensory loss-temp/pinprick-maligancy parestehia/numbness (check if not diabetic aetiology)
Weakness/paralysis
Bladder dysfunction-lower cord-CAUDA EQUINA SYNDROE
Hyperreflexia-early sign-more common malignancies
loss of tone below suspected injury + muscle wasting
Complete cord compression-if high in cervical-quadriplegia and possible loss of rest muscle. can cause Horners syndrome
Cauda equina syndrome-Disc compression and stenosis of canal-saddle parestesia, bower and urinary incontinence, leg weakness
Investigations of Spinal Cord Compression
SPINE MRI and gadolinium enhances spine MRI
Best test to do-shows where compression is
CT spine-same
FBC-can have high WCC in infections and malignancies-same with ESR /CRP
PET scan of spine-high activity-tumours
