Spinal cord compression physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Following a history of acute spinal trauma, the patient should be immobilized with a cervical collar and backboard/head strap. The neurologic exam is started using the American Spinal Injury Association (ASIA) sensory and motor impairment scoring system.

Physical Examination

General Appearance

• Patients may appear in acute distress due to back pain

Vital signs

• Low BP in case of neurogenic shock
• Hypothermia

Back

• Point tenderness at the site of compression
• Decreased range of motion

Neurologic

• {| class="wikitable" ! colspan="3" |ASIA Impairment Scale for Traumatic Spinal Cord Injury |- | rowspan="2" |Grade | colspan="2" |Impairment |- |Sensory |Motor |- |A |Complete loss |Complete loss |- |B |Partial loss |Complete loss |- |C |Partial loss |Partial loss |- |D |Normal |Partial loss |- |E |Normal |Normal |} Paralysis of limbs below the level of compression
• Decreased sensation below the level of compression
• Lhermitte's sign (intermittent shooting electrical sensation)
• Hyperreflexia may be present.
• Babinski sign positive