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→Spinal Cord
=Spinal Cord=
=Spinal Cord=
==Spinal Cord Compression==
*H&P:
*Dx: Sensory level, pain, weakness, numbness, or hyperreflexia below the level of compression, bowel/bladder incontinence and saddle anesthesia with caudal equina. Differential includes tumor, disc herniation, osteomyelitis, epidural abscess, aneurysm, epidural/subdural hematoma, fracture
*Tx: Based on etiology. Don't give steroids for infection. May need neurosurgical decompression.
==Spinal Stenosis==
*H&P: Neurogenic claudication-low back pain that radiates to the buttock that is worse with spinal extension, walking downhill, and standing, better with walking downhill and leaning forward. Negative SLR.
*Dx: Degenerative changes and neuroforaminal narrowing on xray or MRI.
*Tx: NSAIDs, PT, multimodal, MNB, MND, ESI, laminectomy
==Transverse Myelitis==
*H&P: Inflammatory spinal cord process without compression but with weakness, numbness, and autonomic dysfunction below the level of the lesion.
*Dx: Bright area on MRI. Test CSF to rule out HSV, VZV, Lyme, MS.
*Tx: Glucocorticoids. Plasma exchange.
==Cord Syndromes==
Spinothalamic, corticospinal, rubrospinal, dorsal columns, anterior horns, dorsal horns
{| class="wikitable"
|+ Spinal Cord Syndromes
|-
! Syndrome !! Spinal Tracts Involved !! Presentation
|-
| Syrinx || PAG? Anterior white commissure || Loss of pain and temperature bilaterally at the level of the lesion
|-
| Brown-Sequard || Hemi-cord dissection || Contralateral paralysis and hyperreflexia, Ipsilateral loss of pain and temperature below the lesion
|-
| Anterior || Corticospinal, Anterior horns || Ipsilateral LMN syndrome at the level of the lesion
|-
| Posterior || Dorsal columns, Spinothalamic, Dorsal horns || Loss of pain and temperature bilaterally below the level of the lesion
|}