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
Treatment algorithm
Contributors
Authors
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 topic. JSM declares that he has no competing interests.
Peer reviewers
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.
Use of this content is subject to our disclaimer