Spinal cord compression

Question 1

What is spinal cord compression

Answer 1

oncological/medical emergency

extradural compression accounts for majority of cases - usually due to vertebral body metastases

Question 1

Which patients is spinal cord compression most common in

Answer 1

lung , breast and prostate cancer

Question 2

How may someone with spinal cord compression present

Answer 2

back pain
- earliest and most common symptom
- may be worse on lying down/coughing

lower limb weakness

sensory changes

Question 3

What do the neurological signs depend on

Answer 3

level of the lesion
above L1- UMN signs in legs and a sensory level

Below L1 - LMN signs in legs and perianal numbness

Tendon reflexes tend to be increased below level of lesion and absent at level of lesion

Question 4

What investigations are required

Answer 4

urgent whole spine MRI within 24hrs of presentation

Question 5

How do you manage spinal cord compression

Answer 5

high dose oral dexamethasone

urgent oncological assessment