The spinal cord compression and cauda equina syndrome
Compression, or compression of, the spinal cord develops when it is subjected to compression of the bone fragments as a result of spinal fracture, cancer, abscess, damage to the intervertebral disc, spinal injury or other pathological conditions.
Neuropathologically symptoms of spinal cord compression in medical practice are considered as emergency medical conditions, regardless of cause of origin, and require rapid diagnosis and treatment to prevent the development of serious diseases that lead to long-term disability or disability that arose on the background of the development of irreversible spinal cord injury.
Causes and symptoms of compression of the
Compression of spinal roots can occur in any part of the spine, from the cervical to bottom part of the back. The signs of compression — the feeling of numbness, pain and weakness of the muscles which is felt by the patient. Symptoms can develop suddenly or gradually.
The human spine is divided into three different areas: the cervical, thoracic and lumbar. The upper part of the spine — cervical. It supports the neck and consists of 7 vertebrae. The middle part of the spine — thoracic spine consisting of 12 vertebrae. Lower back — lumbar spine, which has five vertebrae. Compression of the spinal cord can occur in any of these parts.
One of the most common causes of spinal cord compression is age-related osteoarthritis, which can cause such a syndrome. It affects the large bones of the spine and develops in patients older than 50 years. Other conditions that can lead to compression of the spinal cord:
- abnormal alignment of the spine;
- trauma of the spine;
- education spinal tumors;
- some diseases of the bones;
- rheumatoid arthritis;
These conditions usually develop rapidly, often are sudden in nature. Syndrome compression can occur at any age.
The main symptoms characterizing the compression of the spinal cord, manifested as back pain, radiating into the legs. In this syndrome pain initially occurs in the gluteal muscles, and then begins to spread down, moving along the back of the thighs.
In some cases deformity of the spine occurs over several years and can cause the following symptoms:
- pain and stiffness in the neck, back or lower back;
- burning pain that spreads to the arms, buttocks, back of legs (sciatica);
- numbness, cramping or weakness in the arms and legs;
- the loss of sensation in the feet;
- difficulty coordinating hands;
- the foot drop is weakness in the foot that causes lameness;
- the loss of sensation in the perineum.
The diagnosis is made by a doctor based on x-ray examination or magnetic resonance imaging the entire spine. X-rays obtained as a result of the survey clearly show the deformation of the bones, the formation of growths and spurs or improper curvatures of the spine.
Cauda equina syndrome: symptoms and causes
Cauda equina syndrome is a serious neurologic condition in which there is damage of nerve endings extending from the coccyx — the lower portion of the spinal cord. The nerve root to join the sacral plexus and affect the sciatic nerve.
Compression, trauma or injury region of the spinal canal in the area of the coccyx can lead to the fact that there is a cauda equina syndrome. The syndrome is characterized by acute pain, accompanied by loss of sensation and paralysis below the located bodies: buttocks, pelvic, legs.
This syndrome often has the following symptoms that require emergency ambulatory care physician:
- loss of control of bowel and bladder;
- temporary or permanent loss of sensitivity of the region between the legs;
- severe pain and muscle weakness;
- the gait disturbance.
The syndrome may occur due to:
- direct trauma;
- spinal stenosis;
- chronic inflammatory condition.
The most common injuries of this nature are lumbar punctures, severe explosion fractures with posterior migration of fragments of the vertebral body, severe herniated disc, failed spinal anesthesia, causing trauma from catheters and high local anaesthetic concentrations around the cauda equina, penetrating injuries (stab and ballistic injuries).
Spinal stenosis occurs in the lumbar region when shrinking the diameter of the spinal canal. The reason for the development of degenerative processes such as osteoarthritis, there may be defects that were present at birth and in the first years of life of the patient.
Also can cause syndrome of chronic inflammatory conditions and diseases of the spine, such as bone Paget’s disease, neurosarcoidosis, chronic inflammatory demyelinating polyneuropathy, ankylosing spondylitis and chronic tuberculosis.
Diagnosing cauda equina syndrome, the doctor evaluates a complete medical history, conducts the examination of the patient and aims at diagnostic study.
To assess the severity of the disease, your doctor may prescribe:
- x-ray examination;
- magnetic resonance imaging (MRI);
- computed tomography (CT).
Who diagnose the disease
The spinal cord compression and cauda equina syndrome can diagnose a group of doctors, consisting of astrology, rheumatologist, practicing bone surgeon, internist, and neurologist.
Many of the causes of spinal cord compression can’t be prevented, but can be alleviated by using measures to prevent spinal cord compression caused by a gradual return wear. To prevent the syndrome through regular exercise, strengthening the muscles that support the back, allowing to keep the spine flexible.
A necessary condition is to maintain good posture and a healthy lifestyle. Patients are advised to sleep on a hard mattress, to use at home hard chairs that support the natural curves of the back.
An important condition is the maintenance of normal body weight. If patient presents with excess weight, the bones of the back are experiencing excessive stress, which may contribute to the development of symptoms of spinal cord compression.