Non-traumatic SCI

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Non-traumatic SCI
2011-07-16 23:19:25
clin path

clin path 3
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  1. Myelopathy
    pathological changes in s.c.; UMN signs, affects all distal
  2. Radiculopathy
    injury to/disease of nerve roots; regional, LMN signs
  3. Intramedullary sc tumor
    inside spinal cord tissue itself; deep burning pain in spinal region; affects sensory tracts; can cause inc intracranial pressue
  4. Extramedullary sc tumor
    outside cord tissue; insidious onset radicular pain; affects nerve root distribution
  5. Presentation of sc tumor
    • pain different for intra vs extra
    • motor weakness- hypo or hyperreflexia
    • sensory changes
    • intramedullary may inc ICP
    • bowel and bladder dysfunction
    • sexual dysfunction
  6. Transverse myelitis
    inflammatory attack across one level of s.c; may be due to autoimmune reaction, response to viral infection, vascular insufficiency/ischemia
  7. Presentation of transverse myelitis
    • UMN signs
    • may develop over several hours to days or 1-2 wks
    • initial- back pain and sensory changes
    • 4 classic features:
    • *weakess of legs/arms
    • *pain
    • *sensory changes
    • *bowel and bladder dysfunction
  8. Spondylosis
    • chronic spinal degeneration, narrowing of spinal canal and IVF
    • painful stiffness in C/S
    • limited side-bending and rotation
    • numbness in UE
    • spatstic LE weakness
  9. Spinal stenosis
    • degenerative narrowing of spinal canal and IVF
    • most common in L/S
    • back pain and sciatica, aggravated by standing and walking
    • neurogenic claudication: gradual onset of weakenss and numbness in LEs when standing/walking
  10. Anklyosing spondylitis
    • rheumatologic condition of spine
    • calcification of ligaments
    • can lead to instability/dislocation
  11. Syringomyelia
    • cycstic cavitation and gliosis in sc
    • cervical or thoracic region
    • can block CSF flow and cause pressure build up --> headaches
    • muscle weakness/atrophy, spasticity in inf segments