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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Spinal cord compression physical examination

Introduction

Overview

Overview

The most significant physical examination findings in acute cases is point tenderness of back. Other physical examination findings include paralysis of limbs below the level of compression, decreased sensation below the level of compression, Lhermitte’s sign (intermittent shooting electrical sensation), hyperreflexia, Babinski sign positive.[1]

Physical Examination

Physical Examination

General Appearance

  • Patients may appear in acute distress due to back pain.

Vital signs

Back

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

Neurologic

ASIA Impairment Scale for Traumatic Spinal Cord Injury♠
Grade Impairment
A
  • Complete: no sensory or motor function is preserved in segments S4–S5.
B
  • Sensory incomplete: sensory but not motor function is preserved below the neurologic level of injury and includes the S4–S5 segment
  • No motor function is preserved more than three levels below the motor level on either side of the body.
C
  • Motor incomplete: motor function is preserved at the most caudal sacral segments for voluntary anal contraction, or sensory function is preserved at the most caudal sacral segments (S4–S5), with some sparing of motor function more than three levels below the motor level on either side of the body.
D
  • Motor incomplete: motor function is incomplete as defined above, with muscle power ≥3 for at least half the key muscle functions below the neurologic level of injury.†
E
  • Normal: sensory and motor function are normal.
♠ Data are adapted from the American Spinal Injury Association (ASIA).

† Muscle power is graded on a scale from 0 (no muscle contraction) to 5 (normal power).

References

References

  1. ↑ Ropper, Alexander E.; Longo, Dan L.; Ropper, Allan H. (2017). “Acute Spinal Cord Compression”. New England Journal of Medicine. 376 (14): 1358–1369. doi:10.1056/NEJMra1516539. ISSN 0028-4793.

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