Acute myelopathy: tumoral or traumatic spinal cord compression

Acute myelopathy in the pediatric population is rare and the clinical presentation is frequently nonspecific, particularly in the younger child; as a result there is a very real risk of missed or delayed diagnosis. If, on the basis of clinical history and detailed examination, there is a possibility of acute spinal cord compression then specialist opinion should be sought to ensure that urgent and appropriate investigations are undertaken in an effort to establish a diagnosis and embark upon treatment. Clearly the management algorithm will be different for acute myelopathy of tumoral origin compared with trauma and so an understanding of the principles of each will enable the nonspecialist to instigate a coordinated management plan. Good functional outcome depends on early treatment to relieve any compressive pathology.