The site of compression is:

thoracic in 70%

lumbosacral 20%

cervical 10%

Lesions above L1 (lower end of spinal cord) will produce upper motor neurone signs and often a sensory level, whereas lesions below L1 will produce lower motor neurone signs and perianal numbness (cauda equina syndrome). Multiple sites of compression may produce different and confusing neurological signs (Table 15.1).

Table 15.1
Neurological signs of upper and lower motor neurone lesions
Upper motor neurone lesion Lower motor neurone lesion

Power

Reduced/absent

Reduced/absent

Tone

Increased

Reduced

Sensation

Sensory loss

Sensory loss

Reflexes (plantars)

Increased (upgoing)

Absent/reduced (downgoing)

Upper motor neurone lesion Lower motor neurone lesion

Power

Reduced/absent

Reduced/absent

Tone

Increased

Reduced

Sensation

Sensory loss

Sensory loss

Reflexes (plantars)

Increased (upgoing)

Absent/reduced (downgoing)

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