Chapter 191: Spinal Cord Diseases
Spinal cord disorders can be devastating, but many are treatable if recognized early (Table 191-1). Knowledge of relevant spinal cord anatomy is often the key to correct diagnosis (Fig. 191-1).
| Compressive |
| Epidural, intradural, or intramedullary neoplasm |
| Epidural abscess |
| Epidural hemorrhage |
| Cervical spondylosis |
| Herniated disk |
| Posttraumatic compression by fractured or displaced vertebra or hemorrhage |
| Vascular |
| Arteriovenous malformation and dural fistula |
| Antiphospholipid syndrome and other hypercoagulable states |
| Inflammatory |
| Multiple sclerosis |
| Neuromyelitis optica |
| Transverse myelitis |
| Sarcoidosis |
| Sjögren-related myelopathy |
| Systemic lupus erythematosus-related myelopathy |
| Vasculitis |
| Infectious |
| Viral: VZV, HSV-1 and 2, CMV, HIV, HTLV-1, others |
| Bacterial and mycobacterial: Borrelia, Listeria, syphilis, others |
| Mycoplasma pneumoniae |
| Parasitic: schistosomiasis, toxoplasmosis, cystercercosis |
| Developmental |
| Syringomyelia |
| Meningomyelocele |
| Tethered cord syndrome |
| Metabolic |
| Vitamin B12 deficiency (subacute combined degeneration) |
| Copper deficiency |
Abbreviations: CMV, cytomegalovirus; HSV, herpes simplex virus; HTLV, human T cell lymphotropic virus; VZV, varicella-zoster virus.
FIGURE 191-1
Transverse section through the spinal cord, composite representation, illustrating the principal ascending (left) and descending (right) pathways. The lateral and ventral spinothalamic tracts ascend contralateral to the side of the body that is innervated. C, cervical; D, distal; E, extensors; F, flexors; L, lumbar; P, proximal; S, sacral; T, thoracic.
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