Cord Compression - Diagnosis and Management
High level ...

Cord Compression - Diagnosis and Management

High level of suspicion in cancer patients with back pain, urinary sx or LE weakness

 • Etiologies: Subacute (tumor/mets, abscesses) vs acute (disc herniation, trauma, hemorrhage)

 • Symptoms: Back pain, motor weakness, hyperreflexia below lesion (*can be hypo in acute or w/cauda equina), +Babinski, loss of sensation (typically c/w dermatome or level), bowel/bladder incontinence OR retention, loss of rectal tone, saddle anesthesia

 • Tests: STAT whole spine MRI w/contrast (cord compression protocol), call MRI 

 • STAT page NSG/Ortho spine +/- Rad Onc for possible XRT if tumor-related

 • Dexamethasone (10mg IV x1 then 4mg IV q6h), esp in malignancy; solumedrol in acute cord injury 2/2 trauma is controversial

#Cord #Compression #Diagnosis #Management #treatment #neurology
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