Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 > Spinal cord compression (N) > Flashcards

Spinal cord compression (N) Flashcards

1
Q

Define spinal cord compression.

A

An injury to the spinal cord resulting from processes that compress or displace arterial, venous and CSF spaces, as well as the cord itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some causes of spinal cord compression? (6)

A
  • infection - discitis, TB, epidural abscess
  • trauma
  • vertebral compression fractures - low energy trauma in patients with osteoporosis/osteomyelitis/elderly
  • vertebral metastases - lung, breast, prostate, renal
  • tumours - primary sarcoma, CNS tumours, multiple myeloma
  • intervertebral disc disease - rupture of the nucleus pulposus in the intervertebral space, through the fibres of the annulus fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What infections can cause spinal cord compression? (3)

A

By external pressure or by direct involvement of the cord:

  • discitis
  • TB (Pott’s disease of the spine)
  • epidural abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are vertebral compression fractures (spinal cord compression)?

A

Low energy trauma in patients with weakened bone e.g. osteoporosis/osteomyelitis/elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which cancers can cause vertebral metastases (spinal cord compression)? (4)

A
  • lung
  • breast
  • prostate
  • renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is intervertebral disc disease (spinal cord compression)?

A
  • rupture of the nucleus pulposus in the intervertebral space, through the fibres of the annulus fibrosis
  • herniation may cause 1+ fragments of the nucleus pulposus to compress/irritate adjacent nerve roots
  • Sx of paraesthesia, pain and weakness are indicative of lumbar radiculopathy or sciatica
  • MRI shows evidence of disc protrusion or extrusion, nerve root impingement, or thecal sac compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most common cause of spinal cord compression?

A

Metastatic spinal cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which causes of spinal cord compression are more common in acute cases? (2)

A
  • trauma
  • disc herniation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which causes of spinal cord compression are more common in chronic cases? (3)

A
  • malignancy
  • osteoporosis
  • osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the most common causes of spinal cord compression by age group? (3)

A
  • 16-30y = trauma
  • 30-50y = herniation (disc disease)
  • 40-75y = malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define cauda equina syndrome (SCC).

A

Lumbosacral nerve roots that extend below the spinal cord are compressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is cauda equina syndrome (SCC) commonly caused by?

A

Disc herniation - L4/L5 or L5/S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the clinical features of cauda equina syndrome (SCC)? (6)

A
  • decreased reflexes
  • saddle anaesthesia
  • faecal incontinence
  • urinary incontinence
  • bilateral sciatica - leg weakness
  • decreased anal tone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do we investigate and treat cauda equina syndrome (SCC)?

A

Urgent MRI spine and then possible surgical decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of condition is acute spinal cord compression?

A

Medical emergency - prevent irreversible spinal cord injury and long term disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical features of spinal cord compression? (6)

A
  • back pain - earliest and most common Sx
  • paraesthesia or numbness/sensory loss AT level of lesion
  • weakness or paralysis bilaterally BELOW affected level of spinal cord
  • loss of tone BELOW affected level of spinal cord
  • bladder/bowel dysfunction - urinary/faecal incontinence
  • hyperreflexia
17
Q

What is a red flag feature of back pain for a tumour or growth in spinal cord compression?

A

Back pain worse when lying down or coughing

18
Q

Where do we see UMN vs LMN signs in spinal cord compression?

A
  • UMN signs below level of lesion
  • LMN signs at level of lesion
19
Q

Where is paraesthesia/numbness/sensory loss seen in spinal cord compression?

A

At level of lesion

20
Q

Where is weakness/paralysis seen in spinal cord compression?

A

Bilaterally below affected level of SC

21
Q

Where is loss of tone seen in spinal cord compression?

A

Below affected level of SC

22
Q

What might we see in central cord syndrome (spinal cord compression)?

A

(Hyperextension + cervical spondylosis) - greater loss of UL function vs LL, including vestibulospinal tract

23
Q

What might we see in Brown-Sequard syndrome (spinal cord compression), and posterior cord syndrome?

A
  • (hemisection) - unilateral spastic paralysis ipsilaterally
  • as well as ipsilateral loss of vibration and proprioception
  • with pain and temperature being lost from contralateral side beginning 1/2 segments below lesion
24
Q

What might we see in anterior cord syndrome (spinal cord compression)?

A
  • loss of motor function below level of injury
  • loss of sensation carried by anterior columns of SC (pain and temperature)
  • preservation of sensation carried by posterior columns of SC (fine touch and proprioception)
25
Q

What are some risk factors for spinal cord compression? (4)

A
  • Hx of trauma including MVA, and high-risk occupation or sports
  • osteoporosis
  • IVDU
  • immunosuppression
26
Q

What are the first-line investigations for spinal cord compression? (4)

A
  • MRI spine
  • gadolinium-enhanced MRI spine
  • plain spine XR
  • CT spine
27
Q

What is the first-line investigation for spinal cord compression?

A

MRI of whole spine within 24h of presentation - may see disc displacement or mass effect

28
Q

What may we see on MRI whole spine in spinal cord compression? (4)

A
  • disc displacement
  • mass effect
  • epidural enhancement
  • T2 cord signal
29
Q

What might we see on spine XR in spinal cord compression? (4)

A
  • decreased disc space height (disc compression)
  • tumour/infection - loss of bony detail
  • trauma - misalignment of vertebral elements
  • infection - loss of end-plate definition
30
Q

What are some differential diagnoses for spinal cord compression? (9)

A
  • transverse myelitis
  • Guillain-Barre syndrome - Hx gastroenteritis (C. jejuni) or influenza-like illness, ascending paralysis
  • HIV-related myelopathy
  • ALS (UMN&LMN, muscle stiffness and atrophy, hyperreflexia)
  • MS
  • diabetic neuropathy
  • peripheral neuropathy
  • polymyositis
  • hereditary muscular dystrophy
31
Q

How do we prevent VTE in spinal cord compression? (2)

A
  • enoxaparin (LMWH)
  • compression stockings
32
Q

How do we manage traumatic spinal cord compression? (3)

A
  • immobilisation (cervical collar or backboard/head strap)
  • decompressive surgery (/stabilisation surgery)
  • IV corticosteroids (e.g. dexamethasone)
33
Q

How do we manage cauda equina syndrome (intervertebral disc compression)?

A

Decompressive laminectomy

34
Q

How do we manage malignancy causing spinal cord compression?

A

High-dose oral dexamethasone
Surgery
Radiation therapy

35
Q

How do we manage an epidural abscess (spinal cord compression)?

A

Vancomycin, metronidazole, cefotaxime and surgery

36
Q

What are some complications of spinal cord compression? (4+3)

A
  • pressure ulcers
  • UTI
  • DVT
  • PEs
  • (discectomy-related complications)
  • (post-operative autonomic complications)
  • (MRSA infections)
37
Q

Describe the prognosis of spinal cord compression.

A

Depends on cause - patient can live with SCC but livelihood may be affected

Year 3 (208 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions