Harrison's Manual of Medicine
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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Citation
Kasper, Dennis L., et al., editors. "Chapter 191: Spinal Cord Diseases." Harrison's Manual of Medicine, 20th ed., McGraw Hill Inc., 2020. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623114/all/Chapter_191:_Spinal_Cord_Diseases.
Chapter 191: Spinal Cord Diseases. In: Kasper DLD, Fauci ASA, Hauser SLS, et al, eds. Harrison's Manual of Medicine. McGraw Hill Inc.; 2020. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623114/all/Chapter_191:_Spinal_Cord_Diseases. Accessed July 27, 2025.
Chapter 191: Spinal Cord Diseases. (2020). In Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (Eds.), Harrison's Manual of Medicine (20th ed.). McGraw Hill Inc.. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623114/all/Chapter_191:_Spinal_Cord_Diseases
Chapter 191: Spinal Cord Diseases [Internet]. In: Kasper DLD, Fauci ASA, Hauser SLS, Longo DLD, Jameson JLJ, Loscalzo JJ, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2020. [cited 2025 July 27]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623114/all/Chapter_191:_Spinal_Cord_Diseases.
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BT - Harrison's Manual of Medicine
UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623114/all/Chapter_191:_Spinal_Cord_Diseases
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