Summary
Definition
History and exam
Key diagnostic factors
- history of mechanical trauma
- past medical history of osteoporosis or neoplasm
- back pain
- bruising
- acute numbness/paresthesia
- weakness
- muscle spasticity/clonus (hypertonicity) or hypotonia
- hyperreflexia or hyporeflexia
- Hoffman sign
- positive Babinski sign
- spinal deformity
- loss of anal sphincter reflex
Other diagnostic factors
- absence of bulbocavernosus reflex (S3-S4)
- signs of spinal shock (hypotonia or flaccidity that resolves within 24 hours)
- urinary incontinence
- painless urinary retention
Risk factors
- male gender
- age >65 years
- concomitant osteoporosis
- previous vertebral fracture
- underlying neoplastic lesion
- underlying metabolic or inflammatory disorders
- falling from a height
- motor vehicle accident
Diagnostic investigations
1st investigations to order
- thoracolumbar spine x-ray (anterior-posterior and lateral views)
Treatment algorithm
Contributors
Authors VIEW ALL
Specialty Registrar
Emergency Medicine
St Thomas’ Hospital
London
UK
Disclosures
BN declares that he has no competing interests.
Consultant Neurosurgeon and Spinal Surgeon
The National Hospital for Neurology and Neurosurgery
London
UK
Disclosures
DC declares that he has no competing interests.
Peer reviewers VIEW ALL
Associate Professor
Department of Orthopedic Surgery and Rehabilitation
Division of Plastic and Reconstructive Surgery
University of Nebraska Medical Center
Omaha
NE
Disclosures
NAN is an author of a reference cited in this monograph.
Professor of Surgery
Division of Neurosurgery
University of Toronto
Physician
Department of Otolaryngology
Sunnybrook Health Sciences Centre
Toronto
Canada
Disclosures
DWR declares that he has no competing interests.
Professor
Division of Neurosurgery
Dalhousie University & QEII Health Sciences Centre
Halifax
Canada
Disclosures
RH declares that he has no competing interests.
Department of Neurological Surgery
Weill Cornell Medical College
New York-Presbyterian Hospital
New York
NY
Disclosures
AT declares that he has no competing interests.
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