Spinal Cord Compression - Radiculopathy

Question 1

what is spinal cord compression

Answer 1

processes that compress or displace arterial, venous, and cerebrospinal fluid spaces, as well as the cord itself

Question 2

what are the causes of spinal cord compression

Answer 2

most cases; trauma or tumours/ metastases compress

Question 3

how can trauma lead to spinal cord compression

Answer 3

direct cord contusion, haematoma, compression by bone fragments and acute disk prolapse

Question 4

risk factors for spinal cord compression

Answer 4

trauma, osteoporosis, metabolic bone disease, vertebral disc disease, malignancy

Question 5

presenting symptoms of cord compression

Answer 5

upper motor neuron signs

sensory disturbance below the lesion

deep and localised back pain

stabbing radicular sensory distrubance at level of lesion

bladder/ bowel incontinence

Question 6

summarise presenting symptoms of spinal cord compression

Answer 6

pain, weakness, sensory loss, saddle anaesthesia etc

Question 7

when will Brown-Sequard syndrome be seen

Answer 7

hemisection of the spinal cord

Question 8

investigations for cord compression

Answer 8

Radiology
Lateral radiographs of spine to look for loss of alignment, fractures etc.
MRI or CT

Bloods - FBC, U&Es, calcium, ESR, immunoglobulin electrophoresis (multiple myeloma)

Urine - look for Bence Jones proteins (multiple myeloma)

Question 9

management

Answer 9

surgical decompression