Spinal cord compression + Cauda Equina Syndrome Flashcards
What are the common causes of spinal cord compression?
- Vertebral trauma
- Trauma
- Inflammatory
- Haematoma
What are the clinical features of Spinal Cord Compression?
- Leg weakness and sensory loss below lesion
- Progressive weakness in legs with UMN lesion and eventual paralysis
- Arms affected if lesion above thoracic spine
- Loss of urinary control
- Painless urinary retention and constipation in later stages
What are the investigations in suspected Spinal cord compression?
=> First line - MRI
- Decompression via laminectomy
- Dexamethasone to reduce oedema around lesion
What is Cauda Equina Syndrome?
- Spinal cord compression occurring below the level of L1, resulting in compression of Cauda Equina
To what regions does the Cauda Equina carry motor innervation to?
- Genitals
- Internal and External Anal Sphincter
- Detrusor Vesicae
- Muscles of leg
- Knee and ankle reflexes
- Skin sensations of legs and pelvis
What are the common causes of Cauda Equina syndrome?
- Lumbar disc herniation
- Spinal stenosis
- Spondylolisthesis (displacement of one vertebrae relative to its immediate inferior vertebrae)
- Trauma
- Growths in the spine
=> Spondylolisthesis can occur as a result of spondylolysis, a congenital or acquired deficiency of the pars interarticularis, usually in the L4/L5 vertebrae
What are the clinical features of Cauda Equina Syndrome?
- Loss of bowel and urinary control
- Decreased sexual function
- Saddle Anaesthesia
- One or both legs impaired - asymmetrical leg pain
- Sciatic pain
- Back pain
- Areflexic paralysis of legs
- Sensory loss of root distribution
- Reduced sphincter tone
What are the investigations in suspected Cauda Equina syndrome?
MRI (preferred) or CT
What is the management of Cauda Equina Syndrome?
=> Depends on cause
=> If caused by disc herniation, trauma, tumours or abscess:
- surgical decompression within 48 hours
- antibiotics for abscess
=> If caused by degenerative disease:
- NSAIDs and corticosteroids
