{"id":2311,"date":"2017-07-07T12:43:38","date_gmt":"2017-07-07T12:43:38","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/neuascc\/"},"modified":"2026-03-10T19:24:06","modified_gmt":"2026-03-10T19:24:06","slug":"neuascc","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/neuascc\/","title":{"rendered":"Clinical Syndromes of Acute Spinal Cord Compression"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The cardinal features of acute spinal cord compression are relatively symmetric\u00a0paralysis of the limbs, urinary retention or incontinence, and a circumferential\u00a0boundary below which there is loss of sensation, referred to as the \u201csensory level\u201d.<br \/>\n<!--more--><br \/>\nHyperreflexia and Babinski signs, which are characteristic of intrinsic diseases of\u00a0the spinal cord, may not be evident in cases of acute and severe cord compression,\u00a0particularly if the cause is trauma. The limbs may instead be flaccid and areflexic,\u00a0accompanied by systemic hypotension, a combination of findings that constitutes\u00a0the syndrome of spinal shock. Localized back or neck pain is an additional\u00a0characteristic of most acute types of cord compression. Variations and partial\u00a0presentations of the typical syndromes are common. The spinal cord\u00a0ends near the L1\u2013L2 level, where it transitions to spinal roots that make up the\u00a0cauda equina. Acute compression of the cauda equina by lesions in the lumbar\u00a0spine causes flaccid paraparesis and early incontinence, findings that are similar\u00a0to those in patients with the syndrome of spinal shock.<br \/>\n<b><\/b><\/p>\n<p><b>Clinical Syndromes of Acute Spinal Cord Compression<\/b><br \/>\nComplete transverse myelopathy (lesion affecting both sides and anterior and posterior spinal cord at one or more segments)<\/p>\n<ul>\n<li>Bilateral paralysis below lowest affected segment of spinal cord<\/li>\n<li>Loss or reduction of all sensation below affected level of spinal cord (sensory level)<\/li>\n<li>Sphincter dysfunction with urinary or bowel urgency, retention, or incontinence<\/li>\n<li>Segmental loss of reflexes at affected level<\/li>\n<li>Hyperreflexia and Babinski signs<\/li>\n<\/ul>\n<p>Spinal shock (acute destruction of spinal cord at one or more cervical or upper thoracic segments)<\/p>\n<ul>\n<li>Paralysis of limbs below the affected segment of the spinal cord<\/li>\n<li>Hypotonia and areflexia of limbs below the level of the lesion<\/li>\n<li>No Babinski signs<\/li>\n<li>Loss of sphincter function<\/li>\n<li>Reduced autonomic function below affected level<\/li>\n<li>Systemic hypotension<\/li>\n<\/ul>\n<p>Central cord syndrome (predominant gray-matter damage, typically involving cervical spine, from trauma)<\/p>\n<ul>\n<li>Weakness and reflex loss in arms; less severe weakness or no weakness in legs<\/li>\n<li>Reduced pain and thermal sense in arms, typically with hyperesthesia, sparing sensation of vibration and proprioception\u00a0in arms and legs<\/li>\n<li>Variable hyperreflexia in legs<\/li>\n<\/ul>\n<p>Hemicord (Brown\u2013S\u00e9quard) syndrome<\/p>\n<ul>\n<li>Paralysis, hyperreflexia, and reduced sensation of vibration on one side of body<\/li>\n<li>Babinski sign on paralyzed side<\/li>\n<li>Loss of pain and thermal sense on opposite side<\/li>\n<\/ul>\n<p>Conus medullaris syndrome (cord compression at the level of L1\u2013L2 vertebral bodies)<\/p>\n<ul>\n<li>Weakness of feet and legs<\/li>\n<li>Variable reflexes in legs<\/li>\n<li>Early loss of sphincter function<\/li>\n<li>Loss of sensation at sacral and lower lumbar (perineal)\u00a0dermatomes; sensory level at or below waist<\/li>\n<li>Variable Babinski signs<\/li>\n<\/ul>\n<p>Cauda equina syndrome (compression between L2 and S1 vertebral bodies)<\/p>\n<ul>\n<li>Sciatic or other radicular pain<\/li>\n<li>Areflexic weakness of feet and legs, depending on level of compression<\/li>\n<li>Sphincter dysfunction<\/li>\n<li>Reduced sensation from saddle region and legs up to groin<\/li>\n<\/ul>\n<p><b>ASIA Impairment Scale for Traumatic Spinal Cord Injury<\/b><br \/>\n<b><\/b><\/p>\n<p><b>Grade Impairment<\/b><\/p>\n<ul>\n<li><b>A Complete:<\/b>\u00a0no sensory or motor function is preserved in segments S4\u2013S5.<\/li>\n<li><b>B Sensory incomplete:<\/b>\u00a0sensory but not motor function is preserved below the neurologic level of injury and includes\u00a0the S4\u2013S5 segments; no motor function is preserved more than three levels below the motor level on either\u00a0side of the body.<\/li>\n<li><b>C Motor incomplete:<\/b>\u00a0motor function is preserved at the most caudal sacral segments for voluntary anal contraction,\u00a0or sensory function is preserved at the most caudal sacral segments (S4\u2013S5), with some sparing of motor\u00a0function more than three levels below the motor level on either side of the body.<\/li>\n<li><b>D Motor incomplete:<\/b>\u00a0motor function is incomplete as defined above, with\u00a0muscle power &gt;3 for at least half the key\u00a0muscle functions below the neurologic level of injury.*<\/li>\n<li><b>E Normal:<\/b>\u00a0sensory and motor function are normal.<\/li>\n<\/ul>\n<p>* Muscle power is graded on a scale from 0 (no muscle contraction) to 5 (normal power).<\/p>\n<p>&nbsp;<\/p>\n<p><b>References:<\/b><\/p>\n<ol>\n<li>Ropper AE, Ropper AH. Acute Spinal Cord Compression. N Engl J Med. 2017 Apr 6;376(14):1358-1369.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28379788\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>O&#8217;Phalen KH, Bunney EB, Kuluz JW. Emergency Neurologic Life Support: Spinal Cord Compression. Neurocrit Care. 2015 Dec;23 Suppl 2:S129-35.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26438458\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Vavourakis M, Sakellariou E, Galanis A, Karampinas P, Zachariou D, Tsalimas G, Marougklianis V, Argyropoulou E, Rozis M, Kaspiris A, Pneumatikos SG. Comprehensive Insights into Metastasis-Associated Spinal Cord Compression: Pathophysiology, Diagnosis, Treatment, and Prognosis: A State-of-the-Art Systematic Review. J Clin Med. 2024 Jun 19;13(12):3590. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38930119\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jul 7, 2017.<br \/>\nUp-date Mar 10, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[2],"tags":[631],"class_list":["post-2311","post","type-post","status-publish","format-standard","hentry","category-neurology","tag-clinical-syndromes-of-acute-spinal-cord-compression"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2311","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2311"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2311\/revisions"}],"predecessor-version":[{"id":10692,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2311\/revisions\/10692"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2311"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2311"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2311"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}