Spinal cord compression (non-traumatic): Difference between revisions
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==Background==
==Background==
*Most often from cancer
*Most often from cancer
*The cauda equina (Latin for "horse's tail") begins at the 2nd Lumbar space extending down to the beginning of the sacral nerves.  It is distal to the tapered end of the spinal cord, or conus medularis.<ref>Cohen MS, Wall EJ, Kerber CW, et al. The Anatomy of the Cauda Equina on CT Scans and MRI.  J Bone Joint Surg Br 1991; 73 (3): 381-84.</ref>


==Diagnosis==
==Diagnosis==

Revision as of 03:58, 7 April 2015

Background

  • Most often from cancer
  • The cauda equina (Latin for "horse's tail") begins at the 2nd Lumbar space extending down to the beginning of the sacral nerves. It is distal to the tapered end of the spinal cord, or conus medularis.[1]

Diagnosis

  • MRI is study of choice
    • If unavailable consider CT myelography

Differential Diagnosis

Lower Back Pain

Treatment

  1. Consult neurosurgery and/or rad onc
  2. Corticosteroid therapy
    1. Extremely controversial and perhaps no longer indicated in nontraumatic compression[2][3]
    2. Consider emergent radiation, surgical intervention, and/or chemo therapy

Disposition

  • Admit

See Also

References

  1. ↑ Cohen MS, Wall EJ, Kerber CW, et al. The Anatomy of the Cauda Equina on CT Scans and MRI. J Bone Joint Surg Br 1991; 73 (3): 381-84.
  2. ↑ Coleman WP, et al: A critical appraisal of the reporting of the National Acute Spinal Cord Injury Studies (II and III) of methylprednisolone in acute spinal cord injury. J Spinal Disord 2000; 13:185.
  3. ↑ Hurlbert RJ: Methylprednisolone for acute spinal cord injury: An inappropriate standard of care. J Neurosurg 2000; 93(1 Suppl):1
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