Spinal Cord Compression

Question 1

Is spinal cord compression an emergency?

Answer 1

yes

Question 2

The majority of cases are due to X compression due to X

Answer 2

Extradural

Vertebral body metastases.

Question 3

In what cancers is cord compression more prevalent?

Answer 3

Lung, breast and prostate cancer.

Question 4

What are some features of spinal cord compression?

Answer 4

• Back pain - the earliest and most common symptom - may be worse on lying down and coughing
• Lower limb weakness sensory changes: sensory loss and numbness
• Neurological signs depend on the level of the lesion.
  
  • Lesions above L1 usually result in upper motor neuron signs in the legs and a sensory level.
  • Lesions below L1 usually cause lower motor neuron signs in the legs and perianal numbness.
  • Tendon reflexes tend to be increased below the level of the lesion and absent at the level of the lesion

Question 5

How do you manage spinal cord compression?

Answer 5

1. High dose oral dexamethasone
2. Urgent oncological assessment for consideration of radiotherapy or surgery.