Cervical myelopathy: symptoms, causes, examination, treatment
The spinal cord is an important part of the body. It acts as a conductor, which 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, the genitourinary system and others. Any damage to this department is fraught with terrible consequences and can instantly put a person in a wheelchair.
What a disease
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 disease, a corresponding prefix is added to the term.
For example, cervical myelopathy suggests that the localization of the pathological process is observed in the cervical spine.
Why there is
No one is insured against the development of the disease. She appears suddenly and introduces the person in perplexity.
The most common causes of spinal cord injury include:
- injury due to falls, accidents, strokes;
- postoperative complications;
- hernia, protrusion, tumor;
- fractures and sprains of vertebrae;
- rib damages;
- all kinds of infections;
- autoimmune pathologies;
- systemic inflammatory diseases;
- blood supply disorder;
- spinal vascular thrombosis;
- tuberculosis of bones;
The hereditary diseases associated with the accumulation of phytic acid( Refsum's disease) and the presence of motor-sensory disorders( Russi-Levi syndrome) play a significant role in the onset of pathology.
In various diseases of the spine, nerve cells of the spinal cord are damaged, a pathology called "amyotrophic lateral sclerosis syndrome"( ALS).
General symptoms of
Symptoms of myelopathy of the cervical can occur gradually or at one time. The latter is most typical for mechanical action on the spine, for example, impact, fracture, displacement.
A sick person can sense:
- Severe pain of different locations.
- Decrease or total loss of sensitivity below the lesion.
- Numbness and tingling of the fingers, hands and feet.
- Paralyzed limbs or whole body.
- Dysfunction of the digestive and genitourinary system.
- Weakness of individual muscles.
Symptoms of vertebrogenic cervical myelopathy may also be present:
- Motion coordination problems.
- Marble complexion.
- Excessive sweating.
- Heart rate disturbance.
- Excessive emotionality, compulsive states.
- Fear of approaching death and stuff.
The bright beginning accompanies illness or disease not always. In some cases, complaints can be minor and progress for a long time.
These patients rarely visit the health care facility at the initial stages, writing off the deterioration of well-being for fatigue and other reasons.
The further course of the disease depends on many factors, but the earlier it is revealed, the more a person gets the chance to return to a healthy and fulfilling life.
The following types of disease occur against the background of direct effects on the spinal cord. These are:
- Toxic and radiation. They are extremely rare. May occur as a consequence of previous irradiation in cancer or poisoning with mercury, lead, arsenic and other dangerous compounds. The defeat of the spinal cord 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 paraneoplastic lesion of the central nervous system that occurs against a background of various malignant processes. It can be cancer of the lung, liver, blood, etc.
- Infectious. It flows quite heavily and can be caused by enteroviruses, Lyme disease, AIDS, syphilis, etc.
- Metabolic. The cases of its detection are not diagnosed infrequently. It causes various metabolic disorders and long-term hormonal failures.
- Demyelinating. The result of the CNS neuronal lesion. Can be transmitted genetically or occur during life.
Such lesions are much less common than compression lesions.
Refers to the most common forms. Occurs in the region of the first 7 vertebrae.
May be caused by any of the listed reasons, but most often occurs due to compression, i.e., pressure on the spinal cord.
These can be hernias, tumors and other factors that have a mechanical effect on this important part of the spine.
Often the pathology provokes such diseases:
- scoliosis, etc.
Congenital or acquired defects in large vessels can disrupt the functioning of the spinal cord, provoking its inflammation.
Patients with cervical myelopathy have the most severe and severe complaints.
They have numbness that can begin with the shoulder area and spread to the entire body. There are always violations of the vestibular apparatus causing:
- dizziness, especially when turning the head or lifting up;
- appearance of "flies" before the eyes;
- attacks of panic attacks and the like.
Symptoms of myelopathy of the cervical region are often confused with VSD.After unsuccessful treatment, a more detailed study is carried out to find out the real cause.
This localization is no less dangerous, but in most cases its clinical manifestations are less pronounced.
Unlike myelopathy of the cervical region, the patient may be bothered by:
- feeling of squeezing in the rib and heart area;
- heaviness on inspiration;
- pain sensations of varying intensity;
- weakness and trembling in the hands;
- increased discomfort when tilting and performing physical exercises.
Most often it develops against the background of circulatory disorders, but other reasons also should not be ruled out.
Symptoms of the thoracic form is very similar to the osteochondrosis of this department, although this is a fairly rare pathology of the spine.
During the diagnosis it is important to differentiate it from heart disease and respiratory system.
Lumbar localization of
If the patient has overtaken this form of the disease, problems are observed in the lower part of the trunk. Under the influence of provoking factors suffer:
- legs( paralysis, numbness, tingling, etc.);
- organs of the small pelvis( there are various diseases associated with the violation of their work).
What is above the lumbar part of the disease most often does not affect. The exception is mixed forms, when the entire spinal cord is damaged.
With compression, this happens rarely, most often it is a systemic effect on the spinal cord or the body as a whole( radiation, poisons, infections, etc.).
Symptoms of myelopathy of the cervical spine are observed in part.
In the absence of characteristic symptoms, cervical myelopathy, like other varieties, is not easy to detect.
Feeling that something is going on in the body, the patients turn to the therapist, orthopedist and other specialists who can not establish the cause of the deterioration of well-being or even make an incorrect diagnosis.
The neurologist is engaged in treatment and diagnosis of the disease. First of all, he collects a detailed anamnesis, i.e., a medical history. The patient will need to be informed in detail:
- How long complaints began.
- If he or his close relatives have chronic illnesses.
- What kind of lifestyle does he lead( are there bad habits, etc.).
- Whether it was previously exposed to radiation and contacted with toxic substances, etc.
Based on these data, the specialist will be able to assume the presence of cervical myelopathy, which will need to be confirmed by examination.
You will definitely need to undergo a general and biochemical blood test. If suspected of infection, a sterility check can be assigned.
In parallel, a diagnosis should be carried out, including:
- MRI, CT of the vertebral column;
- angiography of the spinal cord and its puncture.
The resulting material will be sent to the laboratory for bacteriological inoculation and detection of other infections by PCR.
After the exact diagnosis is made and the provoking factor is identified, the necessary treatment will be prescribed, which the neurologist will carry out together with other specialists. Depending on the reason, it can be:
- osteopath and others.
All about the diagnosis of cervical myelopathy can tell only the attending physician.
There is no single regimen for treatment. The scheme is selected individually and depends on many factors, namely:
- causes of the disease;
- age and sex of the patient;
- concomitant pathologies and another.
For the treatment of cervical ischemic myelopathy the following groups of drugs are used:
- is antispasmodic.
- "Xanthinal nicotine".
When toxic lesions are prescribed drugs that allow you to remove harmful substances from the body. When infectious - antiviral, antifungal and antibacterial agents. Such patients should understand that therapy will be lengthy and not always successful.
In the presence of genetic pathologies, it is not possible to eliminate the disease medically. In this case, a lifelong treatment regimen is selected, eliminating or mitigating clinical manifestations.
To help the surgeon resorted to, if the myelopathy of the cervical department was triggered by mechanical factors, such as:
- vertebra dislocation, etc.
As practice shows, when removing benign formations, the patient has many chances to defeat the disease. Therapy with cervical myelopathy in oncology is much more difficult. As a rule, doctors do not undertake any predictions.
In the case of injuries, the result may be different. It all depends on the degree of damage and localization.
Treatment of cervical myelopathy is half way. After the elimination of the underlying disease, the patient is expected to have a long rehabilitation period. It can include:
- all kinds of massages;
- medical gymnastics;
- physiotherapy procedures;
- wearing fixing corsets;
- visits to specialized sanatoriums.
It is absolutely unacceptable to engage in self-treatment of symptoms and causes of cervical myelopathy. Such frivolity is fraught with serious damage to the bone marrow and irreversible paralysis.
Most often, the disease occurs in adulthood, but is often diagnosed among young people and even toddlers.
Cervical myelopathy with ALS syndrome is seen in most of the patients examined. In order to slightly reduce the likelihood of its appearance, you should follow a few simple recommendations:
- start every morning with a little warm-up;
- if the work is associated with prolonged sitting, periodically get up and do various exercises, you can just be like;
- does not slouch;
- include in the diet meat with cartilage and dairy products;
- get rid of bad habits;
- to refuse heavy and poor-quality food;
- eat plenty of vegetables and fruits;
- periodically drink the course of vitamins and minerals;
- in the presence of chronic pathologies in time to undergo treatment;
- discuss with your doctor the possibility of using drugs that protect and repair cartilage tissue( chondroprotectors).
Hearing the diagnosis of "cervical myelopathy," you should not immediately fall into despair and think about oncology. In most cases, pathology is benign in nature. You should be positive and believe in your own recovery, because medicine has long been proven that the effectiveness of therapy is closely related to the patient's mood, even if the prognosis is very unfavorable.