Myelopathies

There could hardly be a more pressing circumstance in the practice of clinical neurology than the need to rapidly establish the diagnosis of acute spinal cord compression and to differentiate it from non-compressive myelopathies. When the acute cord compression is due to a surgically remediable lesion, e.g. a disc protrusion or epidural haematoma, the prognosis for recovery is directly related to the time delay between symptom onset and relief of the compression. The severity of compression and age of patient also influence prognosis.

Causes of acute myelopathy

1 Spinal cord compression

  • Intervertebral disc prolapse
  • Subdural/epidural haematoma
  • Spinal epidural abscess
  • Vertebral fracture or dislocation
  • Craniocervical junction abnormalities
  • Rheumatoid atlantoaxial subluxation/pannus
  • Achondroplasia
  • Mucopolysaccharidosis
  • Juvenile osteochondritis
  • Thalassaemia
  • Arachnoidal cysts
  • Parasitic cysts
  • Dural herniation of the spinal cord

2 Inflammatory and demyelinating

  • Multiple sclerosis
  • Transverse myelitis
  • Acute necrotic myelopathy
  • Devic's neuromyelitis optica
  • Sarcoidosis
  • Osteomyelitis
  • Paget's disease
  • Arachnoiditis
  • Meningeal carcinomatosis

3 Ishemia

  • Anterior spinal artery occlusion
  • Fibrocartilaginous embolism
  • Dissecting aortic aneurism
  • Decompression sickness

4 Haematomyelia

5 Infective

  • Spinal-cord abscess
  • Viral myelitis
  • Schistosomiasis
  • Brucellosis
  • Syphilis

5 Vertebral neoplasms

  • Primary vertebral tumours
  • Sarcoma
  • Myeloma
  • Osteoma
  • Chordoma
  • Haemangioma


The following examinations link to this page:
658
  659
  2216
  2002
  2001
  1688
  1073
  300