Spinal cord compression

Overview of spinal cord compression refers to the nature of the lesions caused spinal cord, spinal nerve root compression and the supply of vascular disease in a group. Etiopathologic etiology and pathogenesis of the disease according to anatomical site can be divided into three categories. 1, spinal diseases : from vertebral fractures, dislocations, disc prolapse and spinal stenosis, spinal tuberculosis, Spinal the original tumor metastases Gong caused. 2, spinal cord lesions : If neurofibroma and meningioma, and other extramedullary tumors, spinal arachnoid Yan, spinal vascular malformation, such as epidural abscess. 3, spinal cord lesions : If tumor, tuberculoma, and bleeding. Pathogenesis lesions can be directly oppression or damage to the spinal cord and spinal nerve roots or the spinal cord passes, bone compression in the opposite wall. Vein compression enable compression plane following the blood returning disruption caused spinal cord edema. Artery compression can corresponding parts of the visceral myeloid ischemia, edema, nerve cells and white qualitative change and soften. Generally, the oppressed often precede chronic damage pyramidal tract, followed by the thalamus and spinal cord after beam. After compression of spinal cord lesion may spinal subarachnoid obstruction, obstruction plane following circulation of cerebrospinal fluid barrier and can lead to abnormal cerebrospinal fluid composition. Clinical manifestations of clinical performance for the different nature of the lesion and the lesion location, the speed of development, the scope of the affected different. If the incidence of spinal cord tumors are usually ease gradually, gradually progress; Spinal metastases and epidural abscess often cause acute symptoms of oppression; Tuberculosis caused by spinal cord compression can alleviate the symptoms can be anxious. Generally speaking, the clinical symptoms of the development process : first, a spinal nerve root compression symptoms : or more often because of a spinal nerve root compression caused burning pain, tearing pain or pain drilling and may radiotherapy to the corresponding section of the skin, When activities spine, coughing, sneezing can cause pain, proper posture will change mitigation, This first episode of radicular pain symptom diagnosis often important significance. Epidural - yim, extramedullary tumors especially neurofibroma and various calendar of the original canal collapse, often over-obvious pain. Location in the root pain can often be found hypersensitivity or unusual, if impaired, can cause segmental feeling numb. If the lesion in the spine, and may stimulate the spinal nerve damage before the root cause of segmental muscle cramps and muscle atrophy. Second, the symptoms of spinal cord compression (1) movement disorders. Anterior spinal cord compression may appear segmental lower motor neuron paralysis symptoms, damage to the ground before the performance angle disclaimer within the limb or trunk muscle atrophy, weakness, muscle defibrillators. When the corticospinal tract damage, the pressure caused the plane following limb spastic paralysis a limb paralysis increased muscle tone, Tendon hyperreflexia, pathological reflex positive. Chronic degenerative conditions, with the side, then spread to the other side; Acute lesions, and often also affect bilateral, and in the early stages of shock cord (the following lesions were physically flaccid paralysis). General about two weeks after a gradual transition to spastic paralysis. If lumbosacral lesions of the upper motor neuron damage symptoms will not occur. (2) sensory dysfunction. When damage to the spinal cord lesion and the thalamus after the beam, caused damage to the plane following the beam somatic sensory obstacles. If damage to the side of the first sensory transduction increased beam Road, showed damage to the plane following the ipsilateral deep feeling of physical barriers and contralateral shallow sensory dysfunction; development of the spinal cord lesion to the Trans-injury damages when it is below the plane had difficulty feeling obstacles. Extramedullary lesion oppression, pain and temperature sense obstacles often from the lower extremities, the pressure to extend the plane; Intramedullary lesions oppression, Wen Cox pain barrier by more from the plane downward. Sensory dysfunction of the plane of the lesion location often larger reference value. (3) abnormal reflex. The lesions were located at the reflex arc damage, the section within the normal physiological reflex weakened or disappeared, help diagnosis. Cone beam damaged side, ipsilateral lesion site following the tendon hyperreflexia, abdominal reflexes and cremaster reflex slow or disappear, Pathological levy positive; When the wave of bilateral pyramidal not timely, following bilateral lesions appeared with both abnormal and pathological reflex levy. (4) autonomic dysfunction : a level below the skin lesions dry, Sweat little toe (HSI) A rough, limb edema. Lumbosacral more chronic myeloid oppression lesions, early urgent urination difficult to control; If the damage to a sharp shock, will automatically voiding and bowel dysfunction, after the transition to incontinent. Lumbar spinal cord lesions, it was manifested as urine, retention. Intramedullary lesions appeared bladder dysfunction than extramedullary lesion morning. Under spinal cord lesion can produce Horner levy. Chronic spinal cord compression process can be experienced spinal cord damage to the trans-trans-damage process of development. This phenomenon extramedullary tumors easier to see. Trans-half damage is damage to the plane following the ipsilateral deep feeling of obstacles and levies and the pyramidal tract contralateral shallow sensory dysfunction (spinal - TURS); Trans-damage is damage Plane deep feeling following bilateral pyramidal tract, and autonomic dysfunction. 3, spinal symptoms : the lesion site can be tenderness, knocking pain, deformity, restricted activities such signs. 4, spinal obstruction : spinal cord compression of the spinal cord disease can occur subarachnoid incomplete or complete obstruction. Performance lumbar puncture for CSF pressure lowering, With the lack of normal breathing and pulse of the cerebrospinal fluid pressure fluctuations, Kuiken tests showed partial or total obstruction. CSF appearance can be yellow or light yellowish, protein increased. After lumbar puncture can often have neurological symptoms aggravated by the right of suspected high cervical lesions lumbar puncture should be careful to avoid aggravating the symptoms. cause respiratory muscle paralysis. 5, Imaging Signs : Where compression myelopathy should be no exception for spinal X-ray inspection levy, Based on the clinical features should be accurate to choose the location shooting to avoid misdiagnosis. Spinal disease itself often diagnosed through the filming of intraspinal tumor may also oppression, Vertebral corresponding muscle damage resulting from quality positive signs, such as the intervertebral foramen to expand, such as pedicle was detected. Lipiodol spinal water or iodine contrast not only to the compression of the spinal cord disease positioning original value, and the nature of the lesions can also reminded us. Spinal cord right arteriography in the diagnosis of vascular malformation of particular value. CT scan of spinal canal stenosis and disc prolapse may help attendance. Spinal MRI can show that as the spinal cord lesion itself.