Spinal Cord Disorders

Spinal cord disorders encompass a wide range of pathologic entities and affect all age groups. Some spinal cord disorders may have catastrophic outcomes if they are not recognized early in the clinical course. The ultimate neurologic outcome with many of these disorders may depend on expeditious recognition in the emergency department (ED), with appropriate initial investigations, neuroimaging, management, and consultation for definitive therapy. Early presentations of spinal cord syndromes are frequently subtle, and diagnosis may be difficult if not impossible in the early stages of disease. As with many disease processes affecting the nervous system, correct diagnosis and appropriate management require knowledge of the anatomic organization of the spinal cord and skill in taking the history and in performing the neurologic examination. This chapter generally is concerned with nontraumatic processes affecting the spinal cord and its vascular supply as well as processes compressing the spinal cord. Spinal cord trauma is discussed in Chapter 43.