Format

Send to

Choose Destination
Am Fam Physician. 2001 Aug 15;64(4):631-8.

Recognizing spinal cord emergencies.

Author information

1
Family Practice Department, State University of New York Health Science Center at Brooklyn College of Medicine, 11203, USA. indani@msn.com

Erratum in

  • Am Fam Physician 2002 May 1;65(9):1751.

Abstract

Physicians who work in primary care settings and emergency departments frequently evaluate patients with neck and back pain. Spinal cord emergencies are uncommon, but injury must be recognized early so that the diagnosis can be quickly confirmed and treatment can be instituted to possibly prevent permanent loss of function. The differential diagnosis includes spinal cord compression secondary to vertebral fracture or space-occupying lesion, spinal infection or abscess, vascular or hematologic damage, severe disc herniation and spinal stenosis. The most important information in the assessment of a possible spinal cord emergency comes from the history and the clinical evaluation. Physicians must look for "red flags"--key historical and clinical clues that increase the likelihood of a serious underlying disorder. In considering diagnostic tests, physicians should apply the principles outlined in an algorithm for the evaluation of low back pain prepared by the Agency for Healthcare Research and Quality (formerly the Agency for Health Care Policy and Research). Computed tomography and magnetic resonance imaging can clearly define anatomy, but these studies are costly and have a high false-positive rate. Referral of high-risk patients to a neurologist or spine specialist may be indicated.

PMID:
11529262
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for American Academy of Family Physicians
Loading ...
Support Center