Spinal cord compression

Question 1

Features: SCC

Answer 1

acute (or less commonly subacute) 1. upper motor neuron signs
2. sensory disturbance below the level of the lesion.
3. Radicular sharping pain at level of injury
4. Deep and localised back pain is often also present
+/- bowel/bladder involvement (cauda equina)

Question 2

SCC: causes

Answer 2

Trauma

Neoplasia (seen in 5-10% of cancer patients, presenting complaint in 20% of these)

Infection (especially TB in at-risk patients)

Disc prolapse

Epidural haematoma

Question 3

malignancy is demonstrated on MRI –> Neoplastic SCC
Mx?

Answer 3

high-dose oral dexamethasone (16g daily)