Gliosis in the spinal cord

Introduction Syringomyelia, also known as syringomyelia, is a slow-moving spinal degenerative disease characterized by cavernous formation and gliosis in the spinal cord. The degeneration of the spinal cord is still carried out after birth. As a result, the position of the conus of the spinal cord located on the side of the terminal head gradually shifts upward, so that the embryo is located in the conus 2 to 3 plane of the conus in the embryo for 56 to 60 days. It is located at the waist 4, at the waist 2 to 3 at birth, and at the level of 1 to 2 at the waist.

Cause

(1) Causes of the disease:

Since the 1960s, countries around the world have been conducting research on the causes of spinal tube defects and brainless malformations. In the 1970s, through a series of animal experiments, clinical observations and comprehensive epidemiological studies, countries Scholars have recognized that neural tube defects are the result of a combination of genetic and environmental factors, including environmental factors including early pregnancy such as radiation, poisons, hormonal drugs, hypoxia acidosis and other adverse stimuli.

(2) Pathogenesis:

The atresia of the neural tube takes about 10 days from the embryo's 17 to 19 days, and the lamina and myocardium differentiated from the mesoderm, a total of 42 pairs of body segments, gradually heal from the 4th to 7th body segments. First, the anterior nerve hole was locked in about 24 days (23 to 26 days), followed by 26 days (26 to 30 days), and the posterior nerve hole was locked. During this period, the mesodermal tissue (body segment) existing between the neural tube and the ectoderm of the skin forms the vertebrae, and the complete vertebral arch healing is completed in the embryo for about 8 weeks. Subsequent to the end of neuroblast formation, the anterior neural tube covering the ectoderm of the skin is further extended to the caudal end. During this period, the outer ectoderm and the mesoderm originated, and vacuolization occurred in the undifferentiated cell group at the end of the anterior neural tube. These vacuoles then merge to form a tubular structure (formation of the posterior neural tube). The two neural tubes eventually bind to form a spinal cord primordia, a process called tube formation. The spinal cord primordium filled in the spinal canal is 40 to 48 days old in the embryo, and the spinal cord ends are degenerated and degenerated to form the spinal cord. The degeneration of the spinal cord is still carried out after birth. As a result, the position of the conus of the spinal cord located on the side of the terminal head gradually shifts upward, so that the embryo is located in the conus 2 to 3 plane of the conus in the embryo for 56 to 60 days. It is located at the waist 4, at the waist 2 to 3 at birth, and at the level of 1 to 2 at the waist.

an examination

Related inspection

Spinal MRI

1. Mild symptoms: The symptoms at the onset are weak and mild muscle atrophy, numbness, enuresis, and sometimes low back pain or leg pain for one side of the lower limbs, but there are also muscle weakness in both lower limbs. Examination showed signs of peripheral nerve damage, namely low muscle tone, flaccid mild muscle weakness, shallow and deep sensation of lower limbs and perineum.

2. Symptoms: The above-mentioned sports and sensory disturbances are more obvious. There are common horseshoe varus deformities, sometimes low back pain, sciatica or urinary incontinence.

3. Severe symptoms: obvious lower extremity muscle strength, or even paralysis; sensation also significantly reduced or disappeared, often accompanied by neurotrophic changes, lower extremity cold, cyanosis, nutritional ulcers. Some of them often have nutritional ulcers in the appendix, and the skin dysfunction in the sacral nerve distribution area is obvious. The long-term lower limbs showed a disabling atrophy and the tendon reflex disappeared or contracted. Foot deformities can occur in patients with a toe, arched foot, varus or eversion. Patients with complete paraplegia and urinary incontinence, and some incontinence for stool and urination. A small number of patients with disc herniation or lumbar spondylolisthesis, there are still symptoms of upper limbs caused by tethered cord.

Differential diagnosis

Differential diagnosis of the formation of cavities in the spinal cord :

1. Spinal cord ischemia: A series of damaging biochemical changes caused by spinal cord ischemia will lead to intracellular calcium accumulation and increased oxygen free radical content, thereby damaging neurons in the spinal cord and causing irreversible damage to the spinal cord. Spinal cord ischemia is less common than cerebral ischemia. The main reasons are: spinal arteriosclerosis is less than cerebral arteries; spinal cord blood supply network is abundant; spinal cord has strong tolerance to ischemia. Spinal cord ischemia caused by lesions in the spinal cord itself, the symptoms may be transient or permanent. After the spinal cord ischemia is gradually severe, it can also be progressive paraplegia, resulting in a sensory loss plane and sphincter disorders such as the bladder.

2. Transverse spinal cord injury: Spinal cord dysfunction caused by infection or infection-induced spinal cord dysfunction leads to nerve impulse blockade of all or most of the nerve bundles, limited to several segments of acute transverse spinal cord inflammation. Most are ill after acute infection or vaccination. It is characterized by paralysis of the limbs below the level of spinal cord lesions, loss of sensation and dysfunction of the bladder, rectum and autonomic nerves. It is one of the common spinal diseases. The onset can be seen in any season, but it is more common in late winter and early spring and late autumn and early winter.

diagnosis:

Symptoms of recessive spina bifida are mainly caused by damage to the spinal cord and spinal nerves of the affected segment, ie, to the extent of compression and nerve damage. Local skin may have increased hair, the skin is inwardly depressed, and some irregular capillary hemangioma or pigmentation may occur early and late, may have occurred in infants and young children, and some symptoms appear in adulthood, which is related to the spine. The fissure causes a series of secondary pathological changes and the ischemic changes of the tethered cord are gradually aggravated. According to its clinical symptoms, there are mild, moderate, and severe symptoms, but there are quite a few patients with spina bifida who do not develop symptoms for life.

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