Spinal cord compression: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
No edit summary
 
(15 intermediate revisions by 6 users not shown)
Line 1: Line 1:
__NOTOC__
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = {{PAGENAME}} |
   Image          = |
   Image          = Spincal cord compression 1.png|
   Caption        = |
   Caption        = A tumor causing spinal cord compression|
   DiseasesDB    = |
   DiseasesDB    = |
   ICD10          = {{ICD10|G|95|2|g|90}} |
   ICD10          = {{ICD10|G|95.2||G|95.2}} |
   ICD9          = {{ICD9|336.9}} |
   ICD9          = {{ICD9|336.9}} |
   ICDO          = |
   ICDO          = |
Line 11: Line 12:
   eMedicineSubj  = |
   eMedicineSubj  = |
   eMedicineTopic = |
   eMedicineTopic = |
   MeshID        = D013117 |
   MeshID        = |
}}
}}
{{SI}}


{{CMG}}
'''For patient information, click [[Spinal cord compression (patient information)|here]]'''
{{Spinal cord compression}}
{{CMG}} ; {{AE}} {{ADG}}<br>
{{SK}} Compression of spinal cord; SCC; Cord compression; Metastatic spinal cord compression; Traumatic spinal cord compression


{{EH}}
==[[Spinal cord compression overview|Overview]]==


==Overview==
==[[Spinal cord compression pathophysiology|Pathophysiology]]==
'''Spinal cord compression''' develops when the [[spinal cord]] is compressed by bone fragments from a vertebral fracture, a [[tumor]], [[abscess]], ruptured [[intervertebral disc]] or other lesion. It is regarded as a [[medical emergency]] independent of its cause, and requires swift [[diagnosis]] and treatment to prevent long-term disability due to irreversible [[spinal cord injury]].


Symptoms suggestive of cord compression are [[back pain]], a [[dermatome]] of increased sensation, [[paralysis]] of limbs below the level of compression, decreased sensation below the level of compression, [[urinary incontinence|urinary]] and [[fecal incontinence]] and/or [[urinary retention]]. [[Lhermitte's sign]] (intermittent shooting electrical sensation) and [[hyperreflexia]] may be present.
==[[Spinal cord compression causes|Causes]]==


Diagnosis is by [[X-ray]]s but preferably [[magnetic resonance imaging]] (MRI) of the whole spine. The most common causes of cord compression are tumors, but [[abscess]]es and [[granuloma]]s (e.g. in [[tuberculosis]]) are equally capable if producing the syndrome. Tumors that commonly cause cord compression are [[lung cancer]] (non-small cell type), [[breast cancer]], [[prostate cancer]], [[renal cell carcinoma]], [[thyroid cancer]], [[lymphoma]] and [[multiple myeloma]].
==[[Spinal cord compression differential diagnosis|Differentiating Spinal Cord Compression from other Diseases]]==


[[Dexamethasone]] (a potent [[glucocorticoid]]) in doses of 16 mg/day may reduce [[edema]] around the lesion and protect the cord from injury. It may be given [[orally]] or [[intravenous]]ly for this indication.
==[[Spinal cord compression epidemiology and demographics|Epidemiology and Demographics]]==


[[Surgery]] is indicated in localised compression as long as there is some hope of regaining function. It is also occasionally indicated in patients with little hope of regaining function but with uncontrolled pain. Emergency [[radiation therapy]] (usually 20 Gray in 5 fractions) is the mainstay of treatment for malignant spinal cord compression. It is very effective as pain control and local disease control. Some tumors are highly sensitive to chemotherapy (e.g. lymphomas, small-cell lung cancer) and may be treated with chemotherapy alone.
==[[Spinal cord compression risk factors|Risk Factors]]==


Once complete paralysis has been present for more than about 24 hours before treatment, the chances of useful recovery are greatly diminished, although slow recovery, sometimes months after radiotherapy, is well recognised.
==[[Spinal cord compression natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==Diagnosis==
[[Spinal cord compression history and symptoms| History and Symptoms]] | [[Spinal cord compression physical examination | Physical Examination]] | [[Spinal cord compression laboratory findings|Laboratory Findings]] | [[Spinal cord compression x ray|X Ray]] | [[Spinal cord compression CT|CT]] | [[Spinal cord compression MRI|MRI]] | [[Spinal cord compression other imaging findings|Other Imaging Findings]] | [[Spinal cord compression other diagnostic studies|Other Diagnostic Studies]]


The median survival of patients with metastatic spinal cord compression is about 12 weeks, reflecting the generally advanced nature of the underlying malignant disease.
==Treatment==
[[Spinal cord compression medical therapy|Medical Therapy]] | [[Spinal cord compression surgery| Surgery]] | [[Spinal cord compression primary prevention|Primary Prevention]] | [[Spinal cord compression secondary prevention|Secondary Prevention]] | [[Spinal cord compression cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Spinal cord compression future or investigational therapies|Future or Investigational Therapies]]


==Source==
==Case Studies==
* Loblaw DA, Perry J, Chambers A, Laperriere NJ. Systematic review of the diagnosis and management of malignant extradural spinal cord compression: the Cancer Care Ontario Practice Guidelines Initiative's Neuro-Oncology Disease Site Group. ''J Clin Oncol'' 2005;23:2028-37. PMID 15774794.
[[Spinal cord compression case study one|Case #1]]


{{CNS diseases of the nervous system}}
{{CNS diseases of the nervous system}}
{{SIB}}
== References ==
{{reflist|2}}


[[Category:Oncology]]
[[Category:Oncology stub]]
[[Category:Medical emergencies]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
{{WH}}
{{WS}}

Latest revision as of 18:33, 18 April 2017

Spinal cord compression
A tumor causing spinal cord compression
ICD-10 G95.2
ICD-9 336.9

For patient information, click here

Spinal Cord Compression Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Differentiating Spinal Cord Compression from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Spinal cord compression On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Spinal cord compression

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Spinal cord compression

CDC on Spinal cord compression

Spinal cord compression in the news

Blogs on Spinal cord compression

Directions to Hospitals Treating Spinal cord compression

Risk calculators and risk factors for Spinal cord compression

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Synonyms and keywords: Compression of spinal cord; SCC; Cord compression; Metastatic spinal cord compression; Traumatic spinal cord compression

Overview

Pathophysiology

Causes

Differentiating Spinal Cord Compression from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Template:CNS diseases of the nervous system

References

Retrieved from "https://www.wikidoc.org/index.php?title=Spinal_cord_compression&oldid=1307951"