spinal cord compression

Question 1

define spinal cord compression?

Answer 1

injury to the spinal cord with neurological symptoms dependent on the site and extent of the injury

Question 2

what are the major causes of spinal cord compression?

Answer 2

trauma and tumours

Question 3

which cancer spread to the bones?

Answer 3

breast, prostate, lung

Question 4

epidemiology of cord compression?

Answer 4

trauma - all ages

malignancy - elderly

Question 5

presenting symptoms of cord compression?

Answer 5

• History of trauma or malignancy
• Back pain – MOST COMMON EARLY SIGN
• Weakness
• Sensory loss
• Disturbance of bowel and bladder function

Question 6

signs of cord compression on physical examination?

Answer 6

•	Sensory Loss - at level of the lesion 
•	Motor  
o	Weakness or paralysis  
o	Foot drop (in acute phase)  
o	UMN signs below the level of the lesion 
o	LMN signs at the level of the lesion  
•	Priapism

Question 7

what is brown squared syndrome?

Answer 7

seen with hemi-section of the spinal cord

• loss of pain, temp and light touch on opposite side
• loss of motor function, vibration, position and deep touch on the same side as cord damage.

Question 8

what is the appropriate investigation for cord compression?

Answer 8

o Urgent MRI of the whole spine
o Bloods looking for calcium (MM)
• Urine - look for Bence Jones proteins (MM)

Question 9

define cauda equina?

Answer 9

o When lumbosacral nerve roots extending below the spinal cord are compressed.

Question 10

what are the causes of caudal equina?

Answer 10

o	Central disc prolapse at L4/5 
o	Other causes include 
-	Tumours 
-	Infection 
-	Trauma 
-	Haematoma

Question 11

features of caudal equina?

Answer 11

o	Lower back pain
o	Bilateral sciatica 
o	Pins and needles/ in perianal region 
o	Saddle anaesthesia
o	Decreased anal tone 
o	Urinary dysfunction – LATE SIGN 
o	Foot drop

Question 12

investigations of caudal equina?

Answer 12

o Urgent MRI within 6 hours