neurologic disorders
Spinal Cord Compression
Introduction
Various lesions can compress the spinal cord, causing segmental sensory, motor, reflex, and sphincter deficits. Diagnosis is by MRI. Treatment is directed at relieving compression. (See also Overview of Spinal Cord Disorders and Compression is caused far more commonly by lesions outside the spinal cord (extramedullary) than by lesions within it (intramedullary). Compression may be Acute Subacute Chronic Acute compressiondevelops within minutes to hours. It is often due to Trauma (eg, Vertebral Compression Fractures with displacement of fracture fragments, acute Metastatic tumor It is occasionally due to abscess and rarely due to spontaneous epidural hematoma. Acute compression may follow subacute and chronic compression, especially if the cause is abscess or tumor. Subacute compressiondevelops over days to weeks. It is usually caused by A metastatic extramedullary tumor A subdural or an epidural abscess or hematoma A cervical or, rarely, thoracic herniated disk Chronic compressiondevelops over months to years. It is commonly caused by Bony protrusions into the cervical, thoracic, or lumbar spinal canal (eg, due to osteophytes or spondylosis, especially when the spinal canal is narrow, as occurs in Lumbar Spinal Stenosis ) Compression can be aggravated by a herniated disk and hypertrophy of the ligamentum flavum. Less common causes include Spinal Cord Arteriovenous Malformations (AVMs) and slow-growing extramedullary tumors. Atlantoaxial Subluxation and other Lesions that compress the spinal cord may also compress nerve roots or, rarely, occlude the spinal cord’s blood supply, causing Spinal Cord Infarction . 