Spinal Cord Compression

Question 1

What is the pathophysiology of Spinal Cord Compression?

Answer 1

1) Bone fragment fractures (rare) - but not common

2) Mass extradural - causing venous outflow obstruction leading to oedema. Increased pressure leads to ischemia.

Question 2

What are some signs and symptoms of SCC?

Answer 2

1) Pain - back pain generally local but might be radicular
2) Neurology - weakness more common than loss of sensation (although eventually get paralyzed)
3) Incontinence retention with flopy anal tone

Question 3

What Ix should you perform if you suspect it and what treatment?

Answer 3

MRI MRI MRI MRI - very time dependent

give 16mg dexamethasone (to keep blood flowing by decreasing oedema)

radiotherapy (palliative)

surgery