Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • motor weakness
  • loss of fine motor coordination
  • spasticity
  • paraesthesia, numbness, dysaesthesia
  • hyperreflexia and ankle clonus
  • pathological reflexes
  • contractures
  • loss of perianal sensation, voluntary anal contraction, and anal tone
  • autonomic dysreflexia
  • syrinx

Other diagnostic factors

  • central (midline) pain
  • girdle pain
  • musculoskeletal or visceral pain
  • unsteady gait
  • urinary incontinence or retention
  • constipation
  • sexual dysfunction
  • non-specific malaise
  • radicular pain

Risk factors

  • spinal cord trauma or ischaemia
  • higher-level spinal cord lesion
  • extremes of age
  • narrow spinal canal
  • male sex

Diagnostic investigations

Investigations to consider

  • MRI spine
  • EMG
  • urodynamic studies
  • bladder ultrasound
  • micturition cysto-urethrogram
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Associate Professor of Surgery (Neurosurgery)

Michigan State University School of Medicine

Clinical Associate Professor of Physical Medicine and Rehabilitation

Wayne State University School of Medicine

Surgical Director Intensive Care

Oakwood Southshore Medical Center

MI

Disclosures

KC declares that he has no conflicts of interest.

Dr Kenneth Casey would like to gratefully acknowledge Dr Jwalant S. Mehta, a previous contributor to this monograph. JSM declares that he has no competing interests.

Peer reviewers VIEW ALL

Medical Director and Director of Spinal Cord Injury Services

Kessler Institute for Rehabilitation

West Orange

Professor

University of Medicine and Dentistry of New Jersey/New Jersey Medical School

Newark

NJ

Disclosures

SK declares that he has no competing interests.

Consultant in Rehabilitation Medicine

Robert Jones and Agnes Hunt Hospital

Oswestry

UK

Disclosures

DS declares that she has no competing interests.

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