# Spinal Cord Compression
-- History: *** malignancy, IVDU, trauma, disc herniation, AC use
-- Clinical/Exam: *** back pain, LE weakness, saddle anesthesia, bowel/bladder dysfunction (incontinence, urgency, retention, loss of rectal tone), hyperreflexia and pos Babinski if chronic, loss of sensation below the affected level of cord
-- Data: *** MRI
-- Etiology/DDx: *** tumor/metastases, trauma, hematoma, vertebral fracture, epidural abscess
The patient's HPI is notable for ***. Exam showed ***. Labwork and data were notable for ***. Taken together, the patient's presentation is most concerning for ***, with a differential including ***.
-- Imaging: *** STAT whole spine MRI with IV contrast
-- Consults: *** neurosurgery, radiation oncology
-- Steroids: *** dexamethasone 10mg IV load, then 4mg q6; taper of 10-14 days, switch to PO when clinically stable
PDF coming soon!
If there is concern for cord compression from tumor (paresis, saddle anesthesia, bladder/fecal incontinence), get an MRI immediately and involve the neurosurgery and radiation therapy teams for guidance of steroids and the timing of surgery vs RT.