ABSTRACT
This chapter aims to provide an overview of the presentation, diagnosis and management of diseases of the spine, and in particular those disease processes that affect the enclosed spinal cord and nerve roots. The great majority of extradural spinal tumours are metastase or tumours of lymphoid origin. The typical presentation is with fever and localized pain. Referred pain and neurological deficit will follow if neurological compression occurs. The diagnosis is established with imaging and microbiological cultures of blood and likely sites of primary infection. Tabes dorsalis is a progressive demyelination of the posterior columns, as a result of untreated syphilis. Clinical features, which may not appear for decades after the initial infection, include weakness, paraesthesia, dysaesthesia, formication and episodes of intense pain. Subacute combined degeneration is a progressive degeneration of the spinal cord due to vitamin B12 deficiency. ‘Combined’ refers to the fact that demyelination affects the lateral columns in addition to the posterior columns.
