(A&E) (Clinical Imaging) (MSK) (Cancer)

Overview

• Spinal cord compression (SCC) results from processes that compress or displace arterial, venous, and cerebrospinal fluid spaces, as well as the cord itself.
• Causes → Trauma, vertebral compression fractures (low energy trauma in patients with osteoporosis or osteomyelitis), vertebral metastases (lung, breast or prostate cancer), intervertebral disc disease (herniation), infection

  • Acute Onset = trauma or disc herniation

  • Chronic Onset = malignancy (vertebral metastases), osteoporosis, osteomyelitis

    <aside> 💡 Metastatic Spinal Cord Compression is most common

    </aside>

Most Common causes by age group:

• 16-30 yrs old → Trauma
• 30-50 yrs old → Disc Disease
• 40-75 yrs old → Malignancy

Making Diagnosis

Clinical Features:

UMN signs below level of lesion. LMN signs at level of lesion.

• Back Pain → earliest and most common symptom (worse when lying down or coughing = red flag for growth or tumour)
• Numbness/Sensory Loss or Paraesthesia
  • Sensory Loss → at level of lesion
• Weakness or Paralysis → bilateral below affected level of spinal cord
• Bladder or Bowel Dysfunction → faecal incontinence + urinary retention
• Hyper-Reflexia