The spinal cord is an important part of the body. It acts as a conductor that transmits signals to all parts of the body from the head and central nervous system. Such a productive interaction allows movement of the limbs, ensures the normal functioning of the gastrointestinal tract, genitourinary system, and more. Any damage to this department is fraught with dire consequences and can put a person in a wheelchair in an instant.
What a sickness
Myelopathy is a generalized term for all conditions that somehow affect the activity of the spinal cord.
The main factors provoking the development of the disease include:
- mechanical damage;
- various diseases.
Depending on the cause of the illness, the appropriate prefix is added to the term.
For example, cervical myelopathy indicates that the localization of the pathological process is observed in the cervical spine.
Why does it occur
No one is immune from the development of the disease. She appears suddenly and confuses the person.
The most common causes of spinal cord injury include:
- injuries due to falls, accidents, impacts;
- postoperative complications;
- hernias, protrusions, tumors;
- scoliosis;
- osteochondrosis;
- spondylarthrosis;
- spondylosis;
- fractures and dislocations of the vertebrae;
- damaged ribs;
- all kinds of infections;
- autoimmune pathologies;
- systemic inflammatory diseases;
- circulatory failure;
- thrombosis of spinal vessels;
- atherosclerosis;
- osteomyelitis;
- bone tuberculosis;
- hematomyelia;
- demyelination.
An important role in the occurrence of pathology is played by hereditary diseases associated with the accumulation of phytanic acid (Refsum's disease) and the presence of motosensory disorders (Roussy-Levi syndrome).
In various diseases of the spine, damage to the nerve cells of the spinal cord is observed, this pathology is called "amyotrophic lateral sclerosis syndrome" (ALS).
Common signs
The onset of symptoms of cervical myelopathy may occur gradually or all at once. The latter is most typical for mechanical impact on the spine, such as impact, fracture, displacement.
A sick person may feel:
- Severe pain of various localization.
- Reduction or complete loss of sensation below the lesion.
- Numbness andtingling of fingers, hands and feet.
- Paralysis of the limbs or the whole body.
- Violation of the digestive system and genitourinary system.
- Weakness of individual muscles.
Symptoms of vertebrogenic cervical myelopathy may also be present:
- Coordination problems.
- Marble complexion.
- Excessive sweating.
- Irregular heart rhythm.
- Excessive emotionality, obsessions.
- Fear of impending death, etc.
A bright beginning does not always accompany the disease. In some cases, complaints may be minor and progress over time.
Such patients rarely visit a medical facility in the initial stages, attributing deterioration of he alth to fatigue and other reasons.
The further course of the disease depends on many factors, but the earlier it is detected, the more chances a person gets to return to a he althy and fulfilling life.
Classification
The following types of disease occur against the background of a direct effect on the spinal cord. This is:
- Toxic and radiation. They are extremely rare. May occur as a result of previous exposure to cancer or poisoning with mercury, lead, arsenic and other dangerous compounds. Spinal cord injury progresses slowly. The appearance of the first symptoms is often associated with previous episodes of oncology, namely the appearance of metastases.
- Carcinomatous. It is a paraneoplasticdamage to the central nervous system that occurs against the background of various malignant processes. It could be cancer of the lung, liver, blood, etc.
- Infectious. It proceeds quite hard and can be caused by enteroviruses, Lyme disease, AIDS, syphilis, etc.
- Metabolic. Cases of its detection are diagnosed infrequently. It is caused by various metabolic disorders and long-term hormonal disruptions.
- Demyelinating. The result of damage to CNS neurons. Can be passed on genetically or occur during life.
Such lesions are much less common than compression lesions.
Cervical lesion
Relates to the most common forms. Occurs in the region of the first 7 vertebrae.
Can be caused by any of the above, but is most commonly caused by compression, i.e. pressure on the spinal cord.
It can be hernias, tumors and other factors that have a mechanical effect on this important part of the spine.
Often, pathology is provoked by such diseases:
- osteochondrosis;
- scoliosis etc.
Congenital or acquired defects of large vessels can disrupt the functioning of the spinal cord, causing inflammation.
Patients with cervical myelopathy have the most pronounced and severe complaints.
They have numbness that can start from the shoulder area and spread to the whole body. There are always violations of the vestibular apparatus, causing:
- dizziness, especially when turning the head or lifting up;
- disorientation;
- appearance of "flies" before the eyes;
- panic attacks and the like.
Often, the symptoms of cervical myelopathy are confused with VVD. After unsuccessful treatment, a more detailed study is carried out to find out the real cause.
Thoracic pathology
This localization is no less dangerous, but in most cases its clinical manifestations are less pronounced.
Unlike cervical myelopathy, the patient may be bothered by:
- squeezing sensation in the ribs and heart;
- heaviness on inspiration;
- pain of varying intensity;
- weakness and trembling in the hands;
- increased discomfort when bending over and exercising.
Most often it develops against the background of circulatory disorders, but other causes should not be ruled out either.
In terms of symptoms, the chest form is very similar to osteochondrosis of this department, although this is a rather rare pathology of the spine.
When making a diagnosis, it is important to differentiate it from diseases of the heart and respiratory system.
Lumbar localization
If the patient is overtaken by this form of the disease, then problems are observed in the lower part of the body. Under the influence of provoking factors suffer:
- legs (paralysis, numbness, tingling, etc.);
- pelvic organs (various diseases associated withdisrupting their work).
What is above the lumbar region, the disease most often does not affect. The exception is mixed forms, when the entire spinal cord is damaged.
This rarely happens during compression, most often it is a systemic effect on the spinal cord or the body as a whole (radiation, poisons, infections, etc.).
Symptoms of cervical myelopathy are partially observed.
Diagnostic Methods
In the absence of characteristic symptoms, cervical myelopathy, like other varieties, is not easy to identify.
Feeling that something is wrong in the body, patients turn to a therapist, orthopedist and other specialists who cannot establish the cause of the deterioration of he alth or even make an incorrect diagnosis.
A neurologist deals with the treatment and diagnosis of the disease. First of all, he collects a detailed anamnesis, that is, a medical history. The patient will need to be told in detail:
- How long ago the complaints started.
- If he or close relatives have chronic diseases.
- What kind of lifestyle does he lead (are there any bad habits, etc.).
- Has he been previously exposed to radioactive irradiation and contact with toxic substances, etc.
Based on these data, the specialist will be able to suggest the presence of cervical myelopathy, which will need to be confirmed with an examination.
You will definitely need to undergo a general and biochemical blood test. If infection is suspected, may be givenchecking her sterility.
In parallel, it is necessary to carry out diagnostics, including:
- x-ray;
- electromyography;
- electroneurography;
- MRI, CT of the spinal column;
- angiography of the spinal cord and its puncture.
The resulting material will be sent to the laboratory for bacteriological culture and detection of other infections by PCR.
After making an accurate diagnosis and identifying the provoking factor, the necessary treatment will be prescribed, which the neurologist will carry out together with other specialists. Depending on the reason, this could be:
- venereologist;
- oncologist;
- vertebrologist;
- osteopath and others.
All about the diagnosis of cervical myelopathy can tell only the attending physician.
Drug therapy
There is no single treatment regimen. The scheme is selected individually and depends on many factors, namely:
- causes of illness;
- severity;
- age and gender of the patient;
- comorbidities and more.
The following groups of drugs are used to treat cervical ischemic myelopathy:
- vasodilating;
- antispasmodic.
These include:
- "No-Shpu".
- "Drotaverine".
- "Vinpocetine".
- "Xanthinol nicotinade".
For toxic lesions, drugs are prescribed to remove harmful substances from the body. Atinfectious - antiviral, antifungal and antibacterial agents. Such patients should be aware that therapy will be lengthy and not always successful.
In the presence of genetic pathologies, it is not possible to eliminate the disease with medication. In this case, a lifelong treatment regimen is selected that eliminates or alleviates clinical manifestations.
Surgery
The surgeon's help is resorted to if myelopathy of the cervical region was provoked by mechanical factors, such as:
- tumors;
- cysts;
- hernias;
- displacement of the vertebrae, etc.
As practice shows, when removing benign formations, the patient has a lot of chances to defeat the disease. Therapy for cervical myelopathy in oncology is much more difficult. As a rule, doctors do not undertake to give any forecasts.
In case of injuries, the result may be different. It all depends on the degree of damage and localization.
Support activities
Cervical myelopathy treatment is half way. After the elimination of the underlying disease, the patient is waiting for a long period of rehabilitation. It may include:
- all kinds of massages;
- therapeutic gymnastics;
- acupuncture;
- physiotherapy treatments;
- electrophoresis;
- wearing fixing corsets;
- visiting specialized sanatoriums.
It is strictly unacceptable to engage in self-treatmentsymptoms and causes of cervical myelopathy. Such frivolity is fraught with serious damage to the bone marrow and irreversible paralysis.
Prevention
Most often the disease occurs in adulthood, but is often diagnosed among young people and even babies.
Cervical myelopathy with ALS syndrome is observed in the majority of examined patients. In order to slightly reduce the likelihood of its occurrence, you should follow a few simple recommendations:
- start every morning with a little warm-up;
- if the work involves sitting for a long time, periodically get up and do various exercises, you can just walk around;
- do not slouch;
- include meat with cartilage and fermented milk products in the diet;
- get rid of bad habits;
- refuse heavy and low-quality food;
- eat more fruits and vegetables;
- periodically drink a course of vitamins and minerals;
- in the presence of chronic pathologies, undergo treatment in a timely manner;
- discuss with your doctor the possibility of using drugs that protect and restore cartilage tissue (chondroprotectors).
Hearing the diagnosis of "cervical myelopathy", you should not immediately fall into despair and think about oncology. In most cases, the pathology is benign. You should tune in positively and believe in your own recovery, because medicine has long proven that the effectiveness of therapy is closely related tothe mood of the patient, even if the prognosis is very unfavorable.
