Spinal cord compression

Question 1

Causes of spinal cord compression?

Answer 1

Trauma
Neoplasia,
Infection - particularly TB,
Disc prolapse
Epidural haematoma

Question 2

Presentation of spinal cord compression?

Answer 2

Back pain (earlies and most common sign).
Lower limb weakness,
Sensory changes,
Bladder/bowel involvement - incontinence or retention.
UMN signs if lesion above L1
LMN signs if lesion below L1

Question 3

Investigations for spinal cord compression?

Answer 3

Whole body MRI within 24 hours of presentation

Question 4

Management of spinal cord compression?

Answer 4

Surgical decompression - urgently, typically within 48hr.
Radiation therapy to reduce tumour burden.
High dose oral Dexamethasone - If malignancy present on MRI or high clinical suspicion. Give alongside PPI.