Spinal cord compression

Question 1

What causes spinal cord compression?

Answer 1

Neoplastic trauma, infection, disc prolapse

Question 2

What are the most common metastatic malignancy of spinal cord?

Answer 2

Thyroid, lung, breast, renal and prostate

Question 3

What traumatic injuries can cause spinal cord compression?

Answer 3

Vertebral fracture or facet joint dislocation

Question 4

What is the infective causes of spinal cord compression?

Answer 4

Abscess formation, TB or fungal

Question 5

Why is disc prolapse a rare cause of spinal cord compression?

Answer 5

as lumber disc herniation typically causes compression of the cauda equina

Question 6

What conditions predispose to spinal cord compression due to narrowing the cord canal?

Answer 6

inflammatory conditons like RA or ankylosing spondylitis or degenerative conditions with ligament flavour hypertrophy, osteophyte formation, spinal stenosis

Question 7

What are the clinical features of spinal cord compression?

Answer 7

sensation and proprioception are impaired at the dermatomal level blow the cord compression, pain thats worse when straining, weakness, UMN signs ( Hypertonia, hyperreflexia babinski sign, clonus) reflexes absent at level of lesion due to LMN compression, autonomic involvement (late stage) so bowel incontinence, urinary retention, constipation, if malignant then weight loss and tiredness, flaccidity

Question 8

What are the differential diagnosis of spinal cord compression?

Answer 8

lumbago, sciatica, cauda equina

Question 9

What are the investigations for spinal cord compression?

Answer 9

MRI of the whole spine, routine blood tests for cause, group and save and clotting

Question 10

What is the management for spinal cord compression?

Answer 10

High does corticosteroids, PPI, decompression

Question 11

What is the prognosis for someone without mobility with spinal cord compression?

Answer 11

only 1/3 of patients regain function