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Spinal cord compression (Aetiology (Trauma
Crush fracture, Neoplastic
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Spinal cord compression
Diagnosis
Examination
Limb exam
Bilateral weakness, sensory loss,
sensory level, bladder/bowel incontience
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Investigations
Bloods
FBC, CRP, U+E, LFT, clotting,
glucose, lipids, blood cultures
Imaging
MRI spine (ASAP)
X-ray (fragments, degeneration)
Bedside
Obs (fever etc, spinal shock)
ECG (AF)
History
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SH
Living arrangements, occupation,
smoking, alcohol, travel
PC/HPC
Lower limb weakness, parasthesia,
bowel/bladder involvement, recent infection/trauma
Management
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Definitive
Conservative
Identify cause
Referral ASAP to neuro, oncology, neurosurgery
Medical
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Steroids
Indication: ASAP for tumour
E.g. dexamethasone
MOA: reduces oedema around tumour,
reducing inflammatory damage
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Pathophysiology
Mechanism
UMN below lesion, LMN at level
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