Cervical spinal cord epidural lesions

Introduction Cervical epidural lesions are one of the clinical manifestations of spinal cord compression, and spinal cord compression is a common disorder in the nervous system. It is a group of intraspinal lesions with space-occupying features. There is obvious progressive clinical manifestation of spinal cord compression. As the etiology develops and expands, the spinal cord, spinal nerve roots, and their supply vessels are oppressed and become increasingly severe, causing pathological changes such as spinal cord edema, degeneration, necrosis, and ultimately leading to spinal cord. Loss of function, limb movement, reflexes, sensation, sphincter function and skin dystrophies below the pressure plane, seriously affecting the patient's life and labor capacity.

Cause

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

Cervical CT examination of neck mobility test neck test

Spinal X-ray

The positive position of the radiograph and the lateral position were added when necessary. The spinal cord injury was observed to observe the presence or absence of fracture dislocation, dislocation and stenosis of the intervertebral space. About 50% of benign tumors may be positive, such as widening of pedicle spacing, pedicle deformation or blurred intervertebral foramen enlargement of posterior margin of vertebral body or osteoporosis and destruction of metastatic tumors. No change, the longer the course of the disease, the higher the incidence of bone changes.

2. Magnetic resonance imaging (MRI)

It can clearly display the tomographic images of different axes, providing a clearer anatomical hierarchy. Providing the most valuable information on the location and nature of the upper and lower margins of the lesions of the spinal cord is the most valuable tool for diagnosing spinal cord lesions.

3.CT

The higher resolution of the tumor is less than 5mm and the image can be detected clearly. Can clearly show the location of the tumor and the relationship between the tumor and the spinal cord.

4. Myelography

A medical unit without MRI or CT equipment can help diagnose.

5. Radionuclide scanning

Applying 99mTc, or 131I (sodium iodide) 10mCi, after full-length scan of the spinal cord after half an hour of puncture in the lumbar puncture, it can accurately judge the pain of patients with obstruction and less reaction.

Differential diagnosis

Differential diagnosis of cervical spinal epidural lesions:

1, complete cervical spinal cord injury: cervical spinal cord injury refers to cervical spine fractures and other cervical spinal cord injuries, manifested as limbs and trunk of varying degrees of paralysis, dysfunction. Patients often have difficulty in breathing due to respiratory muscle spasm, chest tightness, etc., and because of orthostatic hypotension are prone to dizziness, vertigo, and palpitation. Cervical spinal cord injury is divided into complete injury and incomplete injury according to the degree of injury. Complete injury is that there is no sensation when the pointer stabs the anus, and there is no voluntary contraction of the external anal sphincter during anal examination. Incomplete injury is the feeling when the pointer stabs the anus, or the anal external sphincter has an arbitrary contraction when the anus is diagnosed. Usually, the sensory function and motor function of the limbs after cervical spinal cord injury will be restored to varying degrees.

2, upper cervical medullary lesions: upper cervical medullary lesions are due to spinal cord tumors in the cervical spinal cord region two lesions, upper cervical medullary lesions may have occipital, neck pain and paresthesia.

3, cervical spinal cord demyelinating lesions: cervical spinal cord demyelinating lesions is a disease of the cervical spinal cord under pressure to damage the nerve center, when the disease is serious, it can invade the spinal cord anterior horn cells and brainstem nucleus and the brain motor cortex pyramidal cell crisis life.

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