Spinal cord compression

Question 1

Spinal cord compression

Answer 1

Compression of the spinal cord before the end of the spinal cord and start of the cauda equina

Question 2

Features

Answer 2

Back pain (worse on lying down and coughing)

Lower limb weakness

Sensory loss and numbness

Tendon reflexes increased below the level of the lesion and absent at the level of the lesion

Neurological signs depend on the level of the lesion

Question 3

Lesions above L1

Answer 3

Result in UMN signs in legs and a sensory level

Question 4

Lesions below L1

Answer 4

Cause LMN signs in the legs and perianal numbness

Question 5

Investigations

Answer 5

Urgent MRI whole spine within 24h of presentation

Question 6

Management

Answer 6

High dose oral dexamethasone

Question 7

Metastatic causes

Answer 7

Breast

Lung

Prostate