The blood supply of the spinal cord: how to restore it
The blood supply of the spinal cord should be sufficient to ensure that the nervous tissue of the necessary oxygen and nutrients, timely discharge of the products of metabolism. The spinal cord provides a coordination of muscle contractions that result in movement of the joints. Various movement disorders can be explained not only by the defeat of joints and muscles, but also dysfunction of the cells of the spinal cord. For example, lameness is not always associated with disease of the legs, while improper blood supply of the knee joint and degenerative changes are common causes of this symptom. Limping gait can be the result of a disruption of blood flow to the cells of the spinal cord.
The consequences of circulatory disorders of the spinal cord depend on the anatomical features of the feeding vessels, the place of their localization.
The blood vessels that feed the spinal cord
The blood supply of the spinal cord through a system of arteries. It is possible to distinguish several basic elements:
- vertebral artery;
- three spinal arteries;
- vasculature of the soft sheath of the spinal cord;
- group segmental arteries.
Large vertebral artery, the lumen of which may be more than 4 mm, enters the spine through the lumen of the VI cervical vertebra. Its features and main objectives — simultaneous blood flow to the upper part of the spinal cord and the brain.
In the cavity of the skull from the vertebral arteries branch off the spinal arteries, which are located along the spinal canal anywhere along its length beyond the neck area. One major spinal artery runs along the anterior surface, otvetnaya vessels, which penetrate into the center of the spinal cord. An extensive network of capillaries inside provides nourishment to nerve cells.
Along the back surface of the spinal cord there are two arteries, more subtle than the front. They also occur from branches of the deep tissue. Features of this pair of vessels is that their branches set of blood ties with the anterior artery, and form a network enveloping the spinal cord outside. Network associated with blood vessels outside the vertebral column, which predominantly nourish white matter of the spinal cord.
This set of three spinal arteries are necessary, but insufficient blood supply. The fact that as the distance from the cervical increases the resistance to the flow of blood and the diameter of the arteries decreases.
Therefore, at the level of the lower cervical segments in the blood supply to this area contribute and other vessels that originate from branches of the aorta — the largest blood vessel of the body. From the aorta depart vessels at the level of the cervical, intercostal, lumbar, and sacral divisions to ensure a uniform feed of the vertebral column throughout its length.
Small diameter of segmental artery from these major branches penetrate the intervertebral openings of the joints and merge with the network, feeding the spinal cord.
Reasons that violate the the bloodstream, can be divided two groups:
The vessels feeding the spinal cord, are subject to several risks on their way. Blood flow can be inhibited by the following factors:
- muscle spasm;
- a herniated disc;
- the growth of bone and cartilage;
- fragments of bone tissue at the spinal column;
Hampered blood flow in areas of inflammation and medical intervention (e.g., injection of anesthetics). In addition, heart disease, lower blood pressure, lead to insufficient filling of the vessels. The blood prevent atherosclerotic formation on the walls of blood vessels, thrombosis and phlebitis. To pathologies of the blood supply to result in some congenital anomalies such as aneurysm of the arteries and veins of the spinal cord.
Atherosclerosis may be accompanied by degenerative joint diseases. The most common way of combining pathologies of blood supply: atherosclerosis of the aorta and degenerative disc disease. Especially dangerous obstacle for blood flow in the cervical spine where the vertebral artery, working «both sides» — the brain and spinal cord.
When the factors narrowing the lumen of the vertebral artery may occur bleeding (ischemia) of this part. A symptom of this pathology is a headache that starts in the neck and spreads upward in the back of the head, temples, forehead. Movement of the neck increases the pain. Can appear blurred vision: flies, double vision, fog; hearing loss, hypertension. The cause of the narrowing of the artery can be identified if you pay attention to the features of vertigo, which is also a symptom of a dysfunction of the vertebral artery. If dizziness occurs after lifting the head up, the artery constricted due to degenerative disc disease of the joints of the spine. If it occurs as a result of the tilt of the head down, the likely causes are damage to the blood vessels of the brain (atherosclerosis, thrombosis).
The most common cause of impaired blood flow in the vertebral artery is osteoarthritis of the joint between the first and second cervical vertebrae. Osteoarthritis is a leader among the diseases of the joints. It occurs most frequently in the knee joint, not the spine, but on the severity of the manifestations and implications of these options for localization are difficult to compare: if the lesion in the knee joint that limits movement, such a disease in cervical joint leads to sudden drops when turning the head with loss or without loss of consciousness.
The same applies to pain: pain due to poor circulation in the knee joint usually do not cause anxiety, in contrast to the spectrum of pain with the deficiency of blood supply to the spinal cord.
The most common vascular disease of the spinal cord is associated with disturbances of blood flow in the anterior spinal artery. Manifestations depend on the site of occlusion. Observed weakness of the muscles, paralysis of arms and legs. Features of the symptoms in this disease include reduced pain and temperature sensitivity. Disrupted pelvic organs, sphincters. Cause obstruction of blood flow in this case can be as heart disease and blood vessels, and problems of the joints, for example, compression of the artery herniated disc.
Poor circulation occurs when blockage not only arteries but also veins in which blood exits the spine. The most common cause of violations of the outflow of venous blood in the veins is the compression of intervertebral hernia. The symptoms of with similar manifestations in the arteries: impaired sensitivity, dysfunction of the sphincter of the pelvic region.
Lesions of the circulatory system in the spinal cord can be sudden, sharp, and can be chronic. In the second case the symptoms appear at loads and fade away, if the body is provided with passive recreation. This tactic is similar to the behavior in diseases of the musculoskeletal system, when a necessary measure is to limit the load, for example, for the knee joint. When walking you may experience a feeling of weakness in the legs, numbness that take place in a few minutes after stopping.
These symptoms may precede more severe variants of circulatory disorders.
Hemorrhage into the spinal cord (hematomyelia)
Most of the disorders of blood circulation are not associated with rupture of blood vessels; typically occurs only the inhibition of blood flow in arteries and veins. Bleeding most often occurs due to spinal cord injury with destruction of the walls of blood vessels when blood flows into the spinal cord and its surrounding sheath, forming a hematoma. For most of the musculoskeletal system, for example, the knee joint, bruises are not a cause for much concern, in contrast to the hemorrhages in the organs of the Central nervous system, therefore, fractures and injuries, special attention should be given to maintaining the integrity of the brain and spinal cord.
In addition to the injuries causes of bleeding can be infection, tumors, violations of the permeability of walls of blood vessels, problems with blood clotting, autoimmune diseases, connective tissue pathologies, inflammation of the walls of blood vessels of various etiology. Vascular injury to the spinal cord can occur during medical procedures.
In contrast, for example, from hematomas of the knee joint, the consequences of bleeding in the brain can be more serious: the death of nerve cells in the spinal cord, the compression of the nerve fibers that carry signals to various organs and systems. About hemorrhage in the knee is well illustrated by the bruise, but the symptoms of internal bleeding in the spinal cord does not help to diagnose because they are similar to other manifestations of circulatory disorders: disorders of sensation, paralysis of limbs, disorders of urination and defecation. Therefore, for the diagnosis it is necessary to use special methods (magnetic resonance tomography, analysis of samples of cerebrospinal fluid, computed tomography). Hematoma is treatable, its symptoms over time weaken. Sometimes there is a need for surgical removal of the hematoma, as in difficult cases with injuries of the knee joint.
If the hematoma on the knee joint usually goes away without a trace, in the spinal cord remain forever the effects of hemorrhage, as the lost nerve cells are replaced by connective tissue.
Prevention of circulatory disorders of the spinal cord
Relevant interventions for improving blood supply to the spinal cord are:
- prevention of atherosclerosis;
- prevention of degenerative changes in the joints.
This complex takes into account the most frequent causes of all the other prerequisites of violation of blood flow in the spinal cord. Without the help of experts cannot be correct, for example, of hereditary pathology of the blood supply or to diagnose hematomyelia. But to change the way of life it is possible that the joints receive the necessary dose of physical exercise and cholesterol plaques not to clog the vessels.