Spinal Cord Disorders

Abstract

Background: The spinal cord is the main pathway for information, connecting the brain and the peripheral nervous system. Any disorder that results in spinal cord dysfunction will have a dramatic impact on the patient's quality of life. This review focusses on myelopathy, specifically, on the acute and subacute clinical presentations and the inflammatory and vascular etiology of this widespread disorder. Summary: Myelopathy following spinal cord injury is a generic term referring to a lesion that affects the spinal cord following traumatic injury, or autoimmune, infectious, neoplastic, vascular and hereditary degenerative diseases. Depending on the patient's medical history, the underlying clinical syndrome and the temporal course of the manifestation, the clinician must account for a wide range of possible differential diagnoses. Key Messages: Spinal cord disorders pose a tremendous challenge for the clinician, as they show great variability in clinical presentation but can have potentially de-vastating sequelae. The acute and sometimes urgent nature of therapeutic management is highly dependent on the underlying disorder, often necessitating a combination of approaches including surgical or conservative therapies (including immunomodulatory therapy) and an interdisciplinary approach to achieve the best outcomes.

ACR Appropriateness Criteria® Myelopathy: 2021 Update

“…It is a clinical diagnosis based on signs and symptoms of spinal cord dysfunction [1]. Myelopathy can be due to primary intrinsic disorders of the spinal cord and include neoplastic, infectious, inflammatory, neurodegenerative, vascular, nutritional, and idiopathic disorders [2]. More commonly, however, myelopathy is due to secondary conditions, which result in extrinsic compression of the spinal cord.…”