Spinal cord compression

Introduction Compressive myelopathy is a group of intraspinal lesions with a placeholder effect. Changes in the compression of the spinal cord are related to the site of compression, the nature of external compression, and the rate of occurrence. With the development and expansion of the etiology, the spinal cord, spinal nerve roots and their supply vessels are under pressure and become more and more serious. Once they exceed the compensatory capacity, they will eventually cause pathological changes such as spinal cord edema, degeneration, necrosis, and spinal cord hemisection or transverse damage and vertebrae. Blockage of the tube, causing limb movement, sensation, reflex, sphincter function and skin nutritional dysfunction below the pressure plane, seriously affecting the patient's life and labor capacity.

Cause

The causes of the anatomical parts of the lesion can be divided into three categories:

First, spinal disease: can be caused by vertebral fracture, dislocation, disc herniation, spinal stenosis, spinal tuberculosis, primary tumor metastasis of the spine.

Second, extraspinal spinal cord lesions: such as neurofibroma and meningioma, extramedullary tumors, spinal arachnoiditis, spinal vascular malformations, epidural abscess.

Third, intraspinal lesions: such as tumors, tuberculoma, bleeding and so on.

an examination

Related inspection

Spinal MRI

In general, the development of its clinical symptoms is:

First, the symptoms of spinal nerve root compression: often due to compression of one or more spinal nerve roots, causing burning pain, tearing pain or drilling pain, and can be radiated to the corresponding skin segments, when active spinal column, cough, sneezing Caused by increased pain, appropriate changes in body position can be alleviated, this first symptom of root pain often has important diagnostic significance. Dural meningitis, extramedullary tumors, especially neurofibromatosis and various primary causes of spinal canal collapse, root pain is often prominent. Hypersensitivity or abnormal areas can often be found in the root pain area, and if the function is impaired, it can cause segmental sensation. If the lesion is located in the ventral aspect of the spinal cord, it can stimulate and damage the anterior root of the spinal nerve, causing segmental tendon and muscle atrophy.

Second, spinal cord compression symptoms:

(1) Movement disorders:

When the anterior horn of the spinal cord is compressed, there may be symptoms of segmental lower motor neuron spasm, which is manifested by atrophy of the limb or trunk muscle within the range of the damaged anterior horn, muscle weakness, and muscle fibrillation. When the cortical spinal cord is damaged, the limbs of the limbs below the pressure plane are increased, the muscle tension of the limbs is increased, the tendon reflex is hyperthyroidism, and the pathological reflex is positive.

(2) Sensory impairment:

The plane of sensory disturbance often has a great reference value for the location of lesions.

(3) Abnormal reflection

(4) Autonomic dysfunction:

Below the level of the lesion, the skin is dry, sweat is less, the toe (finger) is rough, and the limb is edematous. Chronic compression lesions above the lumbosacral medulla, early urinary urgency is difficult to control; in the case of a sharply impaired shock period, automatic urination and defecation function loss, and later transition to incontinence. Lumbosacral pulp lesions are characterized by urine and stool retention.

Third, the spinal symptoms: the location of the lesion may have tenderness, cramps, deformity, limited mobility and other signs.

Fourth, spinal canal obstruction: oppressive myelopathy can cause spinal cord subarachnoid space incomplete or complete obstruction.

Differential diagnosis

Spinal cord compression: Spinal cord compression occurs after hepatocellular carcinoma has bone metastases. When the fracture is displaced, the broken bone piece and the broken intervertebral disc can be directly pressed into the spinal canal, and the pleated yellow ligament and the rapidly formed hematoma can also compress the spinal cord and compress the spinal cord. Spinal cord compression occurs after hepatocellular carcinoma has bone metastases. When the fracture is displaced, the broken bone piece and the broken intervertebral disc can be directly pressed into the spinal canal, and the pleated yellow ligament and the rapidly formed hematoma can also compress the spinal cord and compress the spinal cord.

Spinal thalamic bundle compression: When the spinal cord is compressed, the dyskinesia occurs before the sensory disturbance. In addition to the compression of the spinal cord tissue, it may be accompanied by blood circulation disorders, cerebrospinal fluid dynamics, and complications such as inflammation and adhesion. Therefore, clinical performance presents diversity and complexity. The spinal cord and spinal nerve roots in the plane of the primary intraspinal tumor are compressed.

Spinal horseshoe involvement: spinal cord, cauda equina or nerve root involvement is one of the symptoms of spinal cord injury. The number of patients with spinal injuries is increasing, depending on the mechanism of damage, and the classification is also different, so it is also difficult to diagnose. However, in fact, as long as the local pathological anatomical features can be grasped, comprehensive diagnosis and judgment can be made under the premise of comprehensive collection of traumatic history, symptoms and signs, and it is not difficult to obtain a correct diagnosis for most cases. On this basis, the treatment problem is also easy to solve. For some patients with clinical difficulties, CT, MRI, CT plus myelography, CTM and other imaging methods can be used.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.