Spinal cord lesions

Introduction Spinal cord lesions include spinal cord tumors, spinal cord non-tumor-like lesions, and spinal cord dysplasia. Spinal cord disease can cause spinal cord compression. Spinal cord compression refers to a group of conditions in which the spinal cord, spinal nerve roots, and their supply vessels are compressed by lesions of various natures. Congenital dysplasia due to this disease often complicated by other congenital anomalies such as skull base depression, cerebellar tonsil sacral spine, spina bifida, scoliosis deformity, etc., and often have a tendency to family disease, it is believed that this disease is related to genetic factors.

Cause

1, congenital dysplasia due to this disease often complicated by other congenital anomalies such as skull base depression, cerebellar tonsillar sacral spine, spina bifida, scoliosis deformity, etc., and often have a tendency to family disease, it is believed that this disease is related to genetic factors.

2, cerebrospinal fluid dysfunction and pathogenesis has not yet unified understanding, clinical work in the common cranial-cervical junction congenital malformation with spinal cord lesions (the cerebellar tonsillar sacral deformity is the most common), more common in the cervical and upper thoracic spinal cord Inside. It is generally believed that cerebellar tonsillar sputum causes poor circulation of cerebrospinal fluid in this part, resulting in damage to the spinal cord.

3, abnormal blood circulation due to the supply of spinal cord blood circulation abnormalities, such as the anterior spinal artery compression or spinal venous return obstruction caused by ischemia, necrosis, liquefaction of the spinal cord tissue, and finally lead to spinal cord lesions. In short, it is not caused by a single cause in different situations, but a syndrome caused by a variety of pathogenic factors.

an examination

Related inspection

Spinal MRI examination touch

Diagnosis: Clinical manifestations vary with the nature of the lesion and the location of the lesion, the rate of development, and the extent of the spread. For example, spinal cord tumors usually progress gradually and gradually progress. Spinal metastases and epidural abscess often cause acute compression symptoms, and spinal cord compression symptoms caused by spinal tuberculosis can be relieved. 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) Dyskinesia: 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 disturbance: The plane of sensory disturbance often has a great reference value for the location of lesions.

(3) Abnormal reflection.

(4) Autonomic dysfunction: The skin below the lesion level 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

Differential diagnosis

Ependymoma

1. Age: Ependymoma occurs mostly after 30 years of age, and astrocytoma occurs mostly in children and adolescents.

2, site: ependymoma is more common in the lower spinal cord, cone and terminal filament, astrocytoma is more common in the cervical spinal cord and upper chest pulp.

3, enhancement: ependymoma edge sharp, clear boundary, more involving the entire spinal cord, astrocytoma irregular enhancement, the boundary is not clear, mostly located in the back of the spinal cord.

2. Acute myelitis

Cause: Viral infection or its autoimmune response.

Clinical manifestations: more common in young adults, often with episodes of upper respiratory tract or digestive tract infections, acute onset, sudden weakness of both lower extremities, and rapid development into sputum within a few hours or days, cerebrospinal fluid examination may have a slight protein or cell number Increase.

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