Spinal Cord Compression

Question 1

What are the features of spinal cord compression?

Answer 1

*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
• Lesions above L1 result in upper motor neurone signs in legs. Lesions below L1 cause lower motor neurone signs in legs and perianal numbness

Question 2

What investigation is required is suspected spinal cord compression?

Answer 2

Whole spine MRI

Question 3

What is the management of spinal cord compression?

Answer 3

• High dose-oral dexamethasone
• Referral urgent oncological assessment (consideration for radiotherapy or surgery to back)
• Neurosurgery team potential involvement