Epidural compression syndromes: Difference between revisions
Ostermayer (talk | contribs) |
No edit summary |
||
| Line 2: | Line 2: | ||
*Includes spinal cord compression, cauda equina syndrome, conus medullaris syndrome | *Includes spinal cord compression, cauda equina syndrome, conus medullaris syndrome | ||
**Presentation and initial management are similar; difference is level of neuro deficit | **Presentation and initial management are similar; difference is level of neuro deficit | ||
**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> | |||
==Etiology== | ==Etiology== | ||
| Line 29: | Line 30: | ||
==Source== | ==Source== | ||
*Tintinalli | *Tintinalli | ||
==References== | |||
<references/> | |||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 04:35, 21 May 2014
Background
- Includes spinal cord compression, cauda equina syndrome, conus medullaris syndrome
- Presentation and initial management are similar; difference is level of neuro deficit
- 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]
Etiology
- Epidural abscess
- Malignancy
- Massive mid-line disk herniation
- Spinal canal hemorrhage
Clinical Features
- Back pain with neuro deficits
- Weakness in lower extremities, paresthesias/sensory deficits, gait difficultly
- Cauda equina syndrome
- Urinary retention with or without overflow incontinence (Sn 90%, Sp 95%)
- Rectal incontinence
- Bilateral sciatica
- Saddle anesthesia
- Decreased anal sphincter tone (60-80% pts)
- Symptoms worsened by coughing (increases intraspinal pressure)
Management
- MRI
- If considering compression due to neoplasm obtain scan of entire spine
- Radiation therapy
- If due to neoplasm
Source
- Tintinalli
References
- ↑ 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.