Disorders of the spinal cord and vertebral bodies

Abstract

The spinal cord extends caudally from the medulla to the first or second lumbar vertebrae in adults and slightly lower in infants. Spinal cord functions are not solely passive but also modulate or generate many afferent and efferent pathways. Spinal cord dysfunction results from traumatic, inflammatory, demyelinating, ischemic, nutritional, and degenerative conditions. The chapter begins with a discussion of common major clinical features and mechanisms of damage of the spinal cord. Clinical signs depend on the level of the spinal cord damage and whether the damage involves part or all of the cord. Diseases affecting the spinal cord may present as degenerative with loss of specific spinal cord elements, focal lesions at one or more level of the spinal cord, or compression of spinal cord nerve roots that are exiting the vertebra. Three common diseases of the spinal cord are discussed in detail, amyotrophic lateral sclerosis, acute transverse myelitis, low back pain with radiculopathy or lumbar spinal stenosis, with attention to their pathophysiology, major clinical features, major laboratory findings, and principles of management and prognosis.