Cord compression

Question 1

2 types of complete cord compression

Answer 1

1. myelopathy
2. cauda equina

Question 2

what is incomplete spinal cord compression

Answer 2

occurs when the spinal cord is partially damaged, meaning some motor or sensory function is preserved below the level of injury

Question 3

what is complete spinal cord compression

Answer 3

refers to an injury where there is total loss of motor, sensory, and autonomic function below the level of the lesion

no preserved function

Question 4

3 types of incomplete cord compression

Answer 4

1. anterior cord syndrome
2. posterior cord syndrome
3. brown sequard syndrome

Question 5

describe sx of myelopathy

Answer 5

• pain (neck, upper or lower limb)
• loss of motor function eg doing buttons on shirt
• loss of sensory function
• urinary and/or faecal incontinence
• possitive hoffman sign
• usually affects cervical spine
• UMN sx

Question 6

what is cauda equina

Answer 6

a rare but serious condition in which the lumbosacral nerve roots that extend below the spinal cord are compressed

mc cause - central disk prolapse

Question 7

sx of cauda equina

Answer 7

• lower back pain
• bilateral sciatica
• saddle anaesthesia
• reduced anal tone
• urinary incontinence
• LMN signs

Question 8

what is antieror cord syndrome

Answer 8

spinal cord injury resulting from reduced blood flow to the front two-thirds of the spinal cord, often due to an occlusion or compression of the anterior spinal artery

Question 9

how does anterior cord syndrome present

Answer 9

• motor paralysis below lesion
• loss of pain and temp below lesion

Question 10

which tracts does anterior cord syndrome affect

Answer 10

1. Lateral corticospinal tracts
2. Lateral spinothalamic tracts

Question 11

what is posterior cord syndrome

Answer 11

incomplete spinal cord injury where the posterior (dorsal) columns of the spinal cord are affected, while the anterior and lateral tracts are mostly spared.

Question 12

what tracts does posterior cord syndrome affect

Answer 12

dorsal columns - fine touch, propioception, vibration

Question 13

how does posterior cord syndrome present

Answer 13

• loss of propioception, vibration, fine touch below lesion
• unsteady wide based gait
• motor is fine, pain and temp is fine

Question 14

what is brown sequard syndrome

Answer 14

an incomplete spinal cord lesion caused by hemisection (damage to one side) of the spinal cord

Question 15

describe brown sequard sx

Answer 15

ipsilateral –> corticospinal + DCML deficit (motor, propiocpetion, fine touch and vibration)

contralateral –> spinothalamic deficit (pain and temp)

all below lesion

Question 16

causes of cord compression

Answer 16

trauma
malignancy
osteophytes
slipped discs
spinal stenosis
myeloma
RA

Question 17

Sx of cord compression

Answer 17

• back pain
• positive hoffmaan sign
• deltopectoral reflex
• crossed abductors
• treacle hands
• babinksy positive
• clonus in foot

Question 18

what is hoffman sign

Answer 18

if u flick middle finger you get thumb and hand muscle flexion

Question 19

dx of cord compression

Answer 19

urgent mri of brain + whole cord
PR –> check anal tone for cauda equina

Question 20

tx of cord compression

Answer 20

urgent IV dexamethasone
surgical decompression