Ultra-high resolution professional medical education poster on COMPRESSIVE MYELOPATHY. Portrait orientation (A1 ratio). Premium conference-quality design with dark navy blue (#0a1628) background gradient to deep teal (#0d3b4f). Clean white and light cyan text. Gold/amber accent lines for section dividers. LAYOUT (top to bottom): --- HEADER BAND (dark navy, full width) --- Large bold white title: "COMPRESSIVE MYELOPATHY" Subtitle in teal: "Spinal Cord Compression: Pathophysiology, Diagnosis & Management" Thin gold horizontal rule below header --- ROW 1: Two columns --- LEFT COLUMN - "DEFINITION & ANATOMY" (teal section header with small icon): Box with white text: "Compressive myelopathy refers to dysfunction of the spinal cord caused by external mechanical compression — from bony, discal, neoplastic, or vascular structures. It is the most common treatable myelopathy in clinical practice." Below: Detailed anatomical cross-section diagram of a cervical vertebra showing: vertebral body, intervertebral disc (nucleus pulposus + annulus fibrosus), spinal cord, posterior longitudinal ligament, ligamentum flavum, facet joints, nerve root exiting foramen. Color-coded: bone = warm beige, disc = pale blue, cord = yellow, ligaments = orange. Clear white labels with thin leader lines. Include a sagittal spine diagram showing C3-C7 levels with osteophytic bar compressing cord at C5-C6, posterior disc herniation at C6-C7, and cord signal change (T2 hyperintensity) shown in bright yellow. RIGHT COLUMN - "CAUSES & RISK FACTORS" (teal section header): Vertical ranked list with colored icons: 🔴 DEGENERATIVE (most common): Cervical spondylosis, osteophytes, ligamentum flavum hypertrophy, OPLL (Ossification of Posterior Longitudinal Ligament) 🟠 DISC DISEASE: Acute/chronic disc herniation, hard disc vs. soft disc 🟡 NEOPLASTIC: Metastatic epidural compression (breast, lung, prostate, kidney, lymphoma, myeloma); intradural extramedullary (meningioma, neurofibroma) 🟢 INFECTIOUS: Epidural abscess, vertebral osteomyelitis (Pott's disease), tuberculosis 🔵 VASCULAR: Epidural hematoma, spinal AVM ⚪ TRAUMATIC: Vertebral fracture-dislocation, acute disc rupture ⚪ CONGENITAL: Atlantoaxial instability, os odontoideum, achondroplasia Risk factors box: Age >50, osteoporosis, prior malignancy, IV drug use, anticoagulation, congenital narrow canal (Pavlov ratio <0.8) --- ROW 2: Three columns --- LEFT COLUMN - "PATHOPHYSIOLOGY" (amber section header): Flowchart arrows downward: [Compression of Cord/Roots] → [Venous congestion & ischemia] → [Demyelination of white matter tracts] → [Axonal injury] → [Gray matter necrosis (severe/chronic)] → [Neurological deficits] Small inset: Cross-section of compressed cord showing anterior horn cells, corticospinal tract, dorsal columns, spinothalamic tract each labeled and color-coded. Arrows showing which tract produces which symptom. MIDDLE COLUMN - "SIGNS & SYMPTOMS" (teal section header): Human body silhouette (front view) with color-coded arrows pointing to regions: HEAD: Lhermitte sign (electric shock sensation on neck flexion) — gold arrow NECK: Pain, stiffness, restricted ROM — red arrow ARMS/HANDS: Radiculopathy, numbness, paresthesias, clumsiness, "glove" sensation, wasting of intrinsic hand muscles — orange arrows TRUNK: Sensory level — yellow band LEGS: Spastic paraparesis, scissor gait, hyperreflexia, Babinski sign, Romberg sign — blue arrows BLADDER: Urgency, retention, incontinence — purple arrow Right sub-box: "Upper vs Lower Motor Neuron Signs" UMN (cord): spasticity, hyperreflexia, Babinski, clonus LMN (root): hyporeflexia, atrophy, fasciculations RIGHT COLUMN - "CLINICAL PEARL BOX" (gold border, dark background): ⚡ CLINICAL PEARLS: • Cervical spondylotic myelopathy is the MOST COMMON myelopathy in adults >50 • Lhermitte sign = pathognomonic electric shock with neck flexion • Back pain at night that worsens lying down → suspect malignancy • Paraplegia >48h from tumor compression = poor prognosis for recovery • MRI T2 hyperintensity in cord = "myelomalacia" — irreversible injury • Pavlov ratio <0.8 (canal/vertebral body width) = congenitally narrow canal • Brown-Séquard syndrome = ipsilateral motor loss + contralateral pain/temp loss (hemisection) • Always image entire spine — 40% have silent metastases at other levels • Differentiate from B12 deficiency (symmetric, no pain, elevated MCV) --- ROW 3: Two columns --- LEFT COLUMN - "DIAGNOSIS" (teal section header): Step flowchart: Step 1: Clinical suspicion (myelopathy signs + imaging criteria) Step 2: MRI spine with gadolinium (FIRST-LINE) — T1: anatomy/bone marrow; T2: cord signal/edema; T1+Gad: enhancement pattern Step 3: CT myelogram (if MRI contraindicated — pacemaker, claustrophobia) Step 4: Plain X-ray (Pavlov ratio, alignment) Step 5: CT (bony detail, OPLL, fracture) Adjuncts: EMG/NCS (radiculopathy), CSF analysis (inflammatory/infectious), Bone scan (metastases) MRI findings table: Condition | T1 Signal | T2 Signal | Enhancement Spondylotic | Normal | Hyperintense (myelomalacia) | None Metastasis | Hypointense | Hyperintense | + with gadolinium Epidural abscess | Variable | Hyperintense | Rim enhancement Meningioma | Isointense | Isointense | Intense uniform RIGHT COLUMN - "TREATMENT" (amber/gold section header): Algorithm split into Conservative vs Surgical: CONSERVATIVE (mild-moderate): • Physical therapy, cervical collar (acute) • NSAIDs for pain • Gabapentin/pregabalin for neuropathic pain • Dexamethasone 10mg IV bolus → 4mg q6h (tumor/abscess emergencies) • Antibiotics + drainage for epidural abscess • Chemotherapy/radiotherapy for radiosensitive tumors SURGICAL (moderate-severe / progressive): • Anterior Cervical Discectomy & Fusion (ACDF) — anterior compression • Posterior Cervical Laminoplasty — multilevel stenosis • Laminectomy ± fusion — posterior decompression • Corpectomy — large anterior osteophytes • Stereotactic body radiotherapy — radioresistant tumors Surgical indications box: Myelopathic signs, failure of conservative Rx >6 weeks, progressive deficit, cord signal change on MRI, spinal instability --- FOOTER BAND --- Small text: Sources: Harrison's Principles of Internal Medicine 22E (2025) | Adams & Victor's Principles of Neurology 12E | Frameworks for Internal Medicine Thin teal bottom rule. Subtle spine icon watermark in corner. DESIGN SPECS: Dark navy/teal premium color scheme. White body text. Teal and gold section headers. All anatomical diagrams photorealistic 3D style. No cartoons. Clean sans-serif typography. Dense but organized. Conference poster quality.

Ultra-high resolution professional medical education poster on COMPRESSIVE MYELOPATHY. Portrait A1 format. Dark navy blue background with teal accents. Premium conference-quality design. HEADER: Large bold white title "COMPRESSIVE MYELOPATHY" with teal subtitle "Spinal Cord Compression: Pathophysiology, Diagnosis & Management". Gold horizontal divider line. SECTION 1 - DEFINITION (teal header icon): White text box: "Compression of the spinal cord by external mechanical structures — bone, disc, tumor, abscess, or hematoma — causing progressive neurological dysfunction. The most common treatable myelopathy in adults." SECTION 2 - ANATOMY DIAGRAM: Detailed sagittal cross-section of cervical spine (C3-C7) showing: vertebral body (beige), intervertebral disc with nucleus pulposus (blue), spinal cord (yellow), osteophytic spondylotic bar compressing cord at C5-C6 (red), posterior disc herniation, ligamentum flavum hypertrophy, T2 hyperintensity signal change in cord (bright). Labeled with white leader lines. Also axial cross-section of compressed cord showing corticospinal tract, dorsal columns, spinothalamic tract, anterior horn - color coded. SECTION 3 - CAUSES (amber header): Color-coded vertical list with icons: RED - Degenerative: Cervical spondylosis, osteophytes, OPLL, ligamentum flavum hypertrophy ORANGE - Disc Disease: Herniated disc, hard disc vs soft disc YELLOW - Neoplastic: Metastases (breast/lung/prostate), meningioma, neurofibroma GREEN - Infectious: Epidural abscess, Pott's disease (TB spondylitis) BLUE - Vascular: Epidural hematoma, AVM GRAY - Traumatic: Fracture-dislocation, subluxation SECTION 4 - PATHOPHYSIOLOGY FLOWCHART: Downward arrows: [Mechanical compression] → [Venous congestion + ischemia] → [Demyelination of white matter] → [Axonal injury] → [Gray matter necrosis] → [Irreversible deficit] SECTION 5 - SIGNS AND SYMPTOMS: Front-view body silhouette with labeled arrows: - Neck: pain, stiffness, restricted ROM - Arms/hands: radiculopathy, paresthesias, intrinsic muscle wasting, clumsy hands - Lhermitte sign: electric shock on neck flexion (gold lightning bolt icon) - Trunk: sensory level - Legs: spastic paraparesis, scissor gait, Babinski sign, hyperreflexia, Romberg sign - Bladder: urgency/retention/incontinence UMN vs LMN comparison table beside silhouette SECTION 6 - DIAGNOSIS ALGORITHM: Stepwise flowchart boxes: 1. Clinical suspicion → MRI spine with gadolinium (first-line) 2. MRI findings: T2 hyperintensity = myelomalacia, T1 hypointense = metastasis, rim enhancement = abscess 3. CT myelogram (MRI contraindicated) 4. CT (bony detail, OPLL) 5. Adjuncts: EMG, CSF, bone scan Small MRI signal table: condition vs T1/T2/enhancement SECTION 7 - TREATMENT: Two-column split: CONSERVATIVE: NSAIDs, gabapentin, cervical collar, dexamethasone 10mg IV (cord compression emergency), antibiotics + drainage (abscess), radiotherapy SURGICAL: ACDF (anterior compression), Laminoplasty (multilevel), Laminectomy+fusion, Corpectomy, Stereotactic body radiotherapy (resistant tumors) Surgical indications: myelopathic signs, failed conservative 6 weeks, progressive deficit, cord signal change CLINICAL PEARLS BOX (gold border): - Cervical spondylotic myelopathy = most common myelopathy in adults over 50 - Lhermitte sign = pathognomonic for cervical cord involvement - Night pain worsening supine = suspect malignancy - Paraplegia over 48h from tumor = poor recovery prognosis - MRI T2 cord signal = myelomalacia, irreversible - Image entire spine — 40% have silent metastases at other levels - Pavlov ratio under 0.8 = congenitally narrow canal - Brown-Sequard = ipsilateral motor loss + contralateral pain/temp loss FOOTER: "Sources: Harrison's Principles of Internal Medicine 22E | Adams and Victor's Principles of Neurology 12E" Small spine anatomy watermark icon. DESIGN: Dark navy #0a1628 background, white body text, teal section headers, gold accents, photorealistic 3D anatomical diagrams, clean sans-serif typography, no cartoons, publication-quality medical poster layout.