Differential Diagnosis for No Leg Motion

The question suggests a possible injury to the vertebral column that has resulted in no leg motion. This could be due to various reasons affecting the spinal cord or the nerves that control leg movement. Here's a differential diagnosis categorized for clarity:

• Single Most Likely Diagnosis

  • Spinal Cord Injury (SCI) at the Thoracic or Lumbar Level: This is the most likely diagnosis because an injury to the spinal cord at these levels can directly affect the nerves responsible for leg movement, leading to paralysis or significant weakness.

• Other Likely Diagnoses

  • Lumbar Disc Herniation: A herniated disc in the lumbar spine can compress nerves that control leg movement, leading to weakness or paralysis.
  • Cauda Equina Syndrome: This condition occurs when the nerves in the spinal canal are compressed, often due to a herniated disc, leading to leg weakness, numbness, and potentially bladder and bowel dysfunction.
  • Spinal Stenosis: Narrowing of the spinal canal can compress the spinal cord or nerves, leading to leg symptoms, especially if the stenosis is in the lumbar region.

• Do Not Miss Diagnoses

  • Spinal Epidural Abscess: An infection in the epidural space surrounding the spinal cord can compress the cord and lead to rapid neurological deterioration, including paralysis.
  • Spinal Hematoma: Bleeding into the spinal canal can compress the spinal cord, leading to acute neurological deficits.
  • Traumatic Vertebral Fracture: A fracture of the vertebrae can destabilize the spine and compress or damage the spinal cord.

• Rare Diagnoses

  • Arteriovenous Malformation (AVM) of the Spinal Cord: An abnormal connection between arteries and veins can lead to spinal cord damage and symptoms like leg weakness.
  • Spinal Cord Tumor: Tumors within the spinal cord (intramedullary) or outside it (extramedullary) can compress the spinal cord, leading to neurological deficits.
  • Transverse Myelitis: Inflammation across a segment of the spinal cord can cause damage and lead to symptoms like leg paralysis.

Each of these diagnoses has the potential to cause significant neurological deficits, including the loss of leg motion, and requires prompt medical evaluation to determine the underlying cause and appropriate treatment.