Spinal cord compression Flashcards Preview

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Flashcards in Spinal cord compression Deck (22):
1

What can cause acute spinal cord compression?

Trauma
Tumours; hemorrhage or collapse
Infection
Spontaneous haemorrhage

2

What can cause chronic spinal cord compression?

Degenerative disease - spondylosis
Tumours
RA

3

What is a complete cord transection?

All motor and sensory modalities affected; sensory and motor level

4

Will patients show an UMN lesion as soon as the cord is transected?

No; initially a flaccid areflexic paralysis
UMN appears later

5

What is brown-sequard syndrome show?

Ipsilateral motor level
Ipsilateral dorsal column sensory level
Contralateral spinothalamic sensory level

6

What mechanism can result in central cord syndrome?

Hyper Flexion or extension injury to already stenotic neck

7

What will be the distribution of central cord syndrome?

Distal upper limb weakness
Cape-like spinothalamic sensory loss
Lower limb power preserved
Dorsal columns preserved

8

What is the presentation of chronic spinal cord compression?

UMN signs predominate

9

What can cause spinal cord compression?

High energy trauma
Tumour
Haemorrhage
Degenerative changes
Infection

10

What are the types of extradural tumours of the spinal cord?

Mets; lung, breast, kidney, prostate

11

What are the types of intradural tumours of the spinal cord?

Extramedullary; meningioma, schwannoma
Intramedullary; astrocytome, ependymoma

12

What will tumours do to the spinal cord?

Slowly compress
Can also cause acute compression by collapse or haemorrhage

13

What is spinal canal stenosis?

Osteophyte formation
Bulging of IV discs
Facet joint hypertrophy
Eventual subluxation

14

What infections can affect the spinal cord?

Epidural; bloodborne, staph, TB
Surgery or trauma

15

What types of haemorrhage can cause spinal cord compression?

Epidural
Subdural
Intramedullary

16

What are risk factors for haemorrhage in the spinal cord?

Trauma
Bleeding diathesis
Anticoags
AVM

17

What are the treatment options for traumatic spinal compression?

Immobilise
ix: CT/MRI
Decompress and stabilise; surgery, traction, external fixation
?Methylprednisolone

18

What is the treatment for metastatic tumours causing spinal compression?

IV dexamethasone THEN investigate; radiotherapy, chemotherapy
Surgical decompression and stabilisation - ONLY if appropriate

19

What is the treatment for primary spinal cord tumours?

Surgical excision

20

Tx for infection of the spinal canal?

Antibiotics
Surgical drainage
Stabilisation if osteomyelitis occured

21

Tx for hemorrhage

Reverse anticoags
Surgical decompression

22

Tx for degenerative disease

Surgical decompression +/- stabilisation