Myelonkompression

Epidurale

Lipomatose der BWS mit hochgradiger Einengung des Duralsackes bei gleichzeitig Vorwölbung der Wirbelkörperhinterkante durch metastatische Durchsetzung mit pathologischer Fraktur. Links Computertomografie, rechts folgend MRT sagittal T2 und T1 sowie 3 Schichten axial T2. In der Computertomografie schon geringe Höhenminderung von BWK 5 und nach dorsal vorwölbender Weichteilanteil der Metastase in BWK 6, in der MRT ca. 4 Wochen später zunehmender Einbruch BWK 5 mit deutlicher Pelottierung des Myelons. Die durale Enge wird durch das dorsale langstreckig epidurale liegende Fett trotz des knöchern eher weiten Spinalkanals verschärft. Weitere Metastasen in zahlreichen anderen Höhen.

Wikipedia • CC BY-SA 4.0

Spinal cord

compression • Spinal cord compression from cervical disc bulge - Ganzer Fall bei Radiopaedia

Radswiki T, Spinal cord compression from cervical disc bulge. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-11950 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Spondylolisthesis - Ganzer Fall bei Radiopaedia

Radswiki T, Spondylolisthesis. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-11965 • CC by-nc-sa 3.0 (modified)

Spinal

epidural abscess • Epidural abscess of the cervical spine - Ganzer Fall bei Radiopaedia

Gaillard F, Epidural abscess of the cervical spine. Case study, Radiopaedia.org (Accessed on 23 Jan 2023) https://doi.org/10.53347/rID-3886 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Discitis osteomyelitis - Ganzer Fall bei Radiopaedia

Gaillard F, Discitis osteomyelitis. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-4751 • CC by-nc-sa 3.0 (modified)

Neurofibromatosis

type 1 • Neurofibromatosis type 1 - Ganzer Fall bei Radiopaedia

Gaillard, F. Neurofibromatosis type 1. Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-9159 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Dens fracture and epidural hematoma - Ganzer Fall bei Radiopaedia

Dixon A, Dens fracture and epidural hematoma. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-31764 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Cervical canal stenosis with cord compression - Ganzer Fall bei Radiopaedia

Conditions R, Cervical canal stenosis with cord compression. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-34114 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Metastatic spinal cord compression - Ganzer Fall bei Radiopaedia

Murphy A, Metastatic spinal cord compression. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-47515 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Metastatic renal cell carcinoma with cord compression - Ganzer Fall bei Radiopaedia

Bickle I, Metastatic renal cell carcinoma with cord compression. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-53397 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Cord compression due to osseous metastases - Ganzer Fall bei Radiopaedia

Dixon A, Cord compression due to osseous metastases. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-53693 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Metastatic cord compression - Ganzer Fall bei Radiopaedia

Bickle I, Metastatic cord compression. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-59919 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Metastatic cord compression - Ganzer Fall bei Radiopaedia

Bickle I, Metastatic cord compression. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-80157 • CC by-nc-sa 3.0 (modified)

Spinal cord

compression • Metastatic thoracic cord compression: prostate carcinoma - Ganzer Fall bei Radiopaedia

Bickle I, Metastatic thoracic cord compression: prostate carcinoma. Case study, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-84400 • CC by-nc-sa 3.0 (modified)

Minimally

displaced unilateral facet fracture of cervical spine can lead to spinal cord injury: a report of two cases. Magnetic resonance imaging using a sagittal short T1 inversion recovery (STIR) sequence and b axial T2 weighted image at C5/6 at re-admission shows disc injury and spinal cord compression by a posterior epidural mass accompanied by an intramedullary signal intensity change at this level. Prevertebral soft-tissue edema, injury of the interspinous ligament, and a narrowed canal also are evident. There is no flow void in right vertebral artery on axial T2 weighted image, suggesting vertebral artery injury

bmcmusculoskeletdisord.biomedcentral.com • CC-by-4.0

Radiopaedia • CC-by-nc-sa 3.0 • de

Spinal cord compression is a surgical emergency, usually requiring prompt surgical decompression to prevent permanent neurological impairment. If the spinal roots below the conus medullaris are involved, it is termed cauda equina syndrome.

Pathology

Etiology

There are numerous causes of cord compression. These can be divided according to the location of the compressing mass:

intervertebral disc
- disc protrusion/disc extrusion
- diskitis osteomyelitis (usually associated with an epidural abscess)
- degenerative anterolisthesis/spondylosis
vertebral
- trauma
  - vertebral fracture (e.g. burst fracture)
  - fracture-dislocation
- tumor
  - vertebral metastasis
  - primary vertebral tumor (e.g. aggressive vertebral hemangioma)
epidural space
dura
intradural space
- nerve sheath tumor (spinal schwannoma or neurofibroma)

Lesions of the cord itself can present in a similar manner to extrinsic cord compression but are usually considered separately (e.g. spinal cord tumors, spinal cord abscess).