Spinal cord syndromes

Background

Anatomy

Spinal cord tracts
  • Dorsal columns
    • Proprioception, vibration
    • Decussation at medulla
  • Corticospinal Tract
    • Voluntary motor
      • Upper extremity fibers more central, lower extremity fibers more lateral
    • Decussation at medulla
  • Spinothalamic
    • Crude touch, pressure, pain, temperature
    • Decussates 1-2 levels above entry point to spinal cord

Types

Spinal Cord Syndromes

Management

  • Consider intubation injuries at C5 or above
  • Consider surgical intervention for:
  • Steroids are no longer recommended
    • Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death.[1]
    • See EBQ:High Dose Steroids in Cord Injury for further discussion

See Also

References

  1. Hurlbert RJ et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2013 Mar;72 Suppl 2:93-105 http://www.ncbi.nlm.nih.gov/pubmed/23417182
Last modified on 30 March 2017, at 13:48