Spinal cord disease: their symptoms and treatment
The spinal cord is the organ of the Central nervous system consisting of nerve cells and fibers located in the spinal canal. It starts from brain and ends in the vertebrae of the lumbar spine and is a long cord, in shape resembling a cylinder. Consists of gray matter which is surrounded on all sides by white matter. Gray matter consist of nerve cells and the processes of nerve cells. Spinal cord lesion can be triggered by various factors. Diseases of the brain and spinal cord, and other disorders of the various departments can cause sensory, motor and autonomic disorders.
The length of the spinal cord of an adult human ranges from 41 to 45 cm Spinal cord regulates all body functions by transmitting nerve impulses to all internal organs.
Symptoms of spinal cord of man and his various diseases are:
- motor impairment of the upper and lower extremities;
- pain in the neck and lower back;
- violation of skin sensitivity;
- frequent urination and incontinence;
- paralysis and atrophy of muscles;
- loss of joint and muscle sensitivity;
- local increase of skin temperature;
- pain in the muscles.
In the spinal cord of man we can distinguish 5 regions: cervical, thoracic, lumbar, sacral, coccygeal. Syndromes of spinal cord lesions differ at different levels and also depending on what substance the affected, gray, or white.
Compressive spinal cord disease
Represent a complex of neurological symptoms that are caused by displacement and deformation of the spinal cord. This can happen when exposed to abnormal formations and displacements of the vertebrae. Compression (pinching) of the spinal cord affects its normal operation.
Epiduralny abscess. The disease, which causes infectious processes in the area of the brain or spinal cord. Can be placed in any Department within the vertebral canal. Causes can include diseases such as otitis media, inflammation of the nasal sinuses, osteomyelitis of the bones. To the causative agent of this disease belongs anaerobic flora, streptococci, staphylococci, Salmonella, fungi and gram-negative rods. Complications may occur meningitis and meningoencephalitis. For the diagnosis of the disease is CT and MRI. The main method of treatment is surgical intervention (performed laminectomy, removal of abscess) in combination with prolonged antimicrobial therapy with the appointment of large doses of antibiotics.
Hematomyelia. Hemorrhage in the spinal cord, showing acute transverse myelopathy, accompanied by severe back pain. Rare, but can develop as a result of injuries (fall from height, gunshot wound, shock, etc.), damage to the spinal blood vessels (vertebral fractures), arterio-venous malformations of the vessels of the spinal cord (thinning and rupture of the vessel walls). Manifestation of symptoms depends on the localization. May develop at the level of the cervical spinal cord, thoracic segments at the level of the lumbar enlargement. Diagnosed using MRI. Treatment involves strict bed rest, local hyperthermia, the use of hemostatic agents. In addition, it is necessary to conduct activities aimed at restoring the functions of the spinal cord.
Other indirect destruction. Compression of the spinal cord can cause arthritic diseases of the spine, the growth epiblema adipose tissue associated with iatrogenic or primary Cushing’s syndrome, certain hematological diseases.
In the case of pathological education is important not the structure and type of tumor, and the place of its localization. Origin and location of the cancer tumour of the spinal cord are classified thus:
To diagnose diseases of the brain and spinal human brain neurosurgeons and oncologists conducted a neurological examination, radiography, MRI, CT. The most effective treatment of spinal cord tumors is surgical intervention. Conservative treatment can cause improvement and contribute to remission, but they are often short and incomplete.
In the treatment of malignant lesions of the spinal cord, additional applied radiotherapy, which delays tumor growth, reduces many neuropathologically symptoms.
The effects of intervertebral hernias
Rupture of the fibrous ring with a change in the location of the nucleus pulposus of the intervertebral disc becomes the cause of intervertebral hernia. Depending on the area of localization and symptoms symptoms of hernias can vary.
The fact of affecting intervertebral hernia of the spinal cord can cause spinal cord brain dysfunction (myelopathy). As a result of disrupted functioning of the vestibular apparatus, the organs of the pelvis, there is weakness of the lower extremities. In some cases, severe pressure on the spinal cord can cause paralysis of the lower body.
The presence of hernia does not always cause patient complaints. Very often no symptoms, making detection of hernia is very difficult and possible only after MRI. However, the presence of hernia can cause patients serious problems. Among them:
- lower back pain (starts from the buttocks and is localized in the posterior or lateral parts of the foot to the knee);
- pain in leg (occur after lower back pain);
- disturbance of sensation in the feet;
- a feeling of weakness in the legs (especially the knees and joints);
- disruption of the urogenital sphere;
- numbness in the area of the perineum.
In case of serious manifestations of the symptoms of intervertebral hernia should immediately see a specialist, it often causes complications include the large size of the hernias.
Risk factors for herniated discs is Smoking, overweight, high growth, classes connected with physical stress on the spine.
Treatment of intervertebral hernias in most cases, non-surgical and involves the use of anti-inflammatory drugs, manual therapy, strengthening exercises. Surgical treatment of hernias are shown in disturbances of the functions of the spinal cord, with progressive neurological deficits and if the patient experiences severe pain.
Non-compression myelopathy neoplastic
Intramedullary metastasis, radiation and procarcinogen myelopathy. In the diagnosis of these diseases is very difficult to differentiate. The highest probability of intramedullary metastasis, which is often a consequence of bronchial carcinoma, rare — cancers (e.g., breast cancer). CT and MRI visible swelling of the spinal cord with no signs of external compression. Treatment is with radiotherapy.
Progressive necrotic myelopathy. Affects several neighbouring segments of the spinal cord, is a distant effect of solid cancers and combined with low inflammation. Patients develop progressive spastic paraparesis, characterized by asymmetry, paresthesia in the distal extremities, after some time disrupts the function of the organs of the pelvis.
Carcinomatosis meningitis. The CNS in cancer occurring as a result of cancer and not causing myelopathy in that case, if there is proliferation and infiltration of adjacent roots, which result in the infiltration of the spinal cord or nodule formation, and secondary compression.
Malapati and inflammation
Acute myelitis, transverse myelitis and necrotizing myelopathy — a similar disease that leads to inflammation of the spinal cord. Clinical syndrome develops from several days to several weeks. The most common reason is virus infection. Myelitis patient complains of pain in the back and muscle weakness that progresses rapidly. In addition, there are asymmetric ascending paresthesias in the legs.
Infectious myelopathy. Viral damage to the spinal cord are accompanied by specific types of myelitis. In the past the most widely polio, that affects the gray matter. In our time the cause of viral damage to the spinal cord often becomes shingles, at least — lymphotropic virus, HIV.
Arachnoiditis. A variety of inflammatory diseases of the brain and spinal cord in which the lesion occurs in the arachnoid membrane. Reasons can be transferred to various acute and chronic infections, injuries, chronic intoxication, inflammatory diseases of the paranasal sinuses. During treatment, you first need to eliminate the source of infection. Antibiotic treatment, pathogenetic therapy, metabolic therapy.
Angiology is a branch of neuroscience that studies of vascular diseases of the nervous system. Nowadays it is one of the most important health problem because vascular diseases are the cause of death in 12-14% of cases of total mortality. Angioneurology attach great importance to the prevention of vascular diseases of the spinal cord at the level of reason, the development of new preventive methods.
Disease can be caused by a pathological condition of the vessels, causing their destruction, such as venous thrombosis, atherosclerosis, aneurysm, dissection of the arteries, lipohyalinosis, the deposition of amyloid. Disease can develop if increased blood viscosity with inadequate blood flow, reduced perfusion pressure. In addition, the cause may be rupture of the vessel.
Vascular malformation of the spinal cord AVM (arteriovenous malformation) of the spinal cord to its clinical picture may resemble transverse myelitis, multiple sclerosis, spinal stroke, neoplastic compression. Therefore, this disease is considered the most difficult to diagnose. Observed paraparesis, progressive destruction of spinal cord, radicular pain, causing lameness, back pain.
Heart attack and its consequences
Infarction occurs in acute infringement of spinal blood circulation, which upset the function of the spinal cord due to difficulty in blood flow. Can occur in almost any Department that is affected by the reason for developing a heart attack.
It is often difficult to determine what exactly caused the heart attack, but more often it occurs as a result of blood clots in the small blood vessels in which blood flows to the spinal cord, injury extravertebral arteries. Thus a spinal infarction causing thrombosis or dissection of the aorta. In addition, a heart attack can develop when arteriit, serum sickness.
Infarction of the spinal cord is almost always spans multiple departments. Vessels suffer when occlusive thromboangiitis, nodular periarthritis. Total ischemic infarction can often be caused by disorders of the spinal blood circulation or discirculatory Malaysia.
A heart attack may develop even after minor injuries (e.g. during sports). In this case, a heart attack can be caused by microscopic particles of hernias of the intervertebral disc. How do they get into the bone, and from there to the spinal cord is unclear, but in the blood vessels often found pulposa fabric. The symptoms that define a heart attack, are characterized by a sudden severe pain in the back, reduced pain and temperature sensitivity, bilateral flaccid paresis of the extremities. Spinal infarction at the time of its development may cause headache, nausea, fainting, a condition of General weakness.
Infarction most commonly occurs in people aged 50 to 60 years. In patients under the age of 40 infarction is most commonly caused by vasculitis, aortic pathology, chronic periocularly process, and older people — pathologies of the aorta.
A heart attack is diagnosed using MRI. Treatment in most cases is symptomatic.
Spondylosis. Chronic disease of the spine, causing degenerative changes of the intervertebral disc, resulting in compression of the spinal cord and adjacent nerve roots. Depending on the localization is spondylosis of the cervical, thoracic and lumbar spine. Causes the formation of osteophytes (calcification), which narrows the spinal canal and intervertebral holes. They can be complicated by the appearance of hernias of the intervertebral discs. Spondylosis is the next stage of osteoarthritis. Develops as a result of age-related eating disorders of the spine, and trauma due to overload.
This disease most affects people after age 40, especially men. The main symptom is a painful feeling caused by congestion, sharp movements, hypothermia. The pain can cause sleep disorders. In addition, there may be a limitation of the spine. Treatment depends on the type of spondylosis and is comprehensive, aimed at slowing the progression of the disease, reducing symptoms and preventing complications of the disease. In the package of measures included heat, massage, exercise, acupuncture, magnetic-vacuum therapy, the use of herbal remedies that improve circulation.
Lumbar stenosis. Narrowing of the Central spinal canal, causing spinal cord compression with radiating roots. May be both congenital and acquired during life. Congenital narrowing can be caused by a narrow vertebral canal, especially the vertebral, abnormalities in the development of the vertebrae. In addition, the narrowing is due to the reduction and flattening of the vertebrae, displacement of one vertebra relative to another arising from the injury. Also it can cause tumors, osteophytes, disc protrusion, presence of herniated discs. Often congenital acquired factors are applied (combined form of stenosis). For the diagnosis is assigned a fluoroscopic examination, CT, MRI.
Treatment of stenosis primarily involves the use of conservative methods, except in those cases where surgical intervention is necessary.
Degeneration and heredity
Syringomyelia. Chronic disease of the Central nervous system, leading to the defeat of the spinal cord, where it formed a cavity. The pathological process is localized in the cervical and thoracic spine. Patients primarily observed violations of pain, vibration and temperature sensitivity. In addition, it is characterized by autonomic and trophic disorders in the shoulder girdle and upper extremities, joint disorders, movement disorders, atrophic paresis of the muscles.
The main causes of the disease are anomalies in the embryonic development of the CNS, stenosis of the cervical spine, brain tumors, complications of injury to the vertebral column and spinal cord. For accurate diagnosis it is necessary to conduct MRI of the brain and all parts of the spinal cord to assess the localization and size of the cavities. Treatment is symptomatic (drugs that enhance neuromuscular conduction, massages, physical therapy) or surgical (bypass surgery cavities).
Tabes of the spinal cord. Later syphilitic lesions of the nervous system, one of the clinical forms of neurosyphilis. Tabes and syphilis meningovascular in our time are extremely rare. The characteristic symptom is a neuralgic pain shooting from the side of internal organs (stomach, kidney, laryngeal, heart attacks and crises of the rectum) and in the legs, which can be taken for Isias. In addition, there is atrophy of bones and joints, gross ataxia of gait and toes, irregularity of the pupils and absence of their reaction to light. For treatment, use of all drugs antisyphyllitic funds.
In order to prevent the consequences of any disease of the spinal cord as early as possible to diagnose and begin treatment. Therefore, for the manifestation of the symptoms and signs of disturbance of the spinal cord, you should immediately consult a doctor.