Spinal Cord Compression

Question 1

Clinical features of cord compression

Answer 1

• back pain
  > worse on lying down and coughing
• lower limb weakness
• sensory loss and numbness

If lesion above L1 = UMN signs in legs

If lesion below L1 = LMN signs in legs and perianal numbness

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

Question 2

Gold standard investigation for cord compression

Answer 2

MRI whole spine (within 24hrs presentation)

Question 3

Manegement of spinal cord compression

Answer 3

• high-dose oral dexamethasone
• oncology ref for Radiotherapy
• Neurosurgery ref for ?surgical intervention