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, urogenital system and other. 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 that provoke 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 does

No one is insured against the development of the disease. She appears suddenly and introduces the person in perplexity.

To the most widespread reasons provoking defeat of a spinal cord, carry:

• Injuries, due to falls, accidents, blows;
• Postoperative complications;
• Hernias, protrusions, tumors;
• scoliosis;
• Osteochondrosis;
• Spondylarthrosis;
• Spondylosis;
• Fractures and dislocations of vertebrae;
• Damage to the ribs;
• All kinds of infections;
• Autoimmune pathologies;
• Systemic inflammatory diseases;
• Violation of blood supply;
• Thrombosis of spinal vessels;
• atherosclerosis;
• osteomyelitis;
• Tuberculosis of bones;
• Hematomyelia;
• Demyelination.

Not the least role in the emergence of pathology is played by hereditary diseases associated with the accumulation of phytic acid (Refsum's disease) and the presence of motor-sensory disorders (Russi-Levi syndrome).

With various diseases of the spine, nerve cells of the spinal cord are damaged, a pathology called "amyotrophic lateral sclerosis syndrome" (ALS).

General features

The appearance of symptoms of myelopathy cervical may occur gradually or at one time. The latter is most typical for mechanical impact on the spine, such as impact, fracture, displacement.

A sick person can feel:

1. Severe pain of different localization.
2. Decrease or total loss of sensitivity below the lesion.
3. Numbness and tingling of fingers, hands and feet.
4. Paralysis of limbs or the whole body.
5. Disorders of the digestive and urogenital system.
6. Weakness of individual muscles.

There may also be symptoms of vertebrogenic cervical myelopathy:

1. Problems with coordination of movements.
2. Marble complexion.
3. Excessive sweating.
4. Violation of the heart rate.
5. Excessive emotions, obsessions.
6. Fear of approaching death and so on.

A bright beginning accompanies the disease not always. In some cases, complaints can be minor and progress for a long time.

Such patients rarely visit the medical facility at the initial stages, writing off the deterioration of the state of health 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 a chance to return to a healthy and fulfilling life.

Classification

The following types of disease occur against a background of direct influence on the spinal cord. It:

1. 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.
2. 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.
3. Infectious. It flows quite heavily and can be caused by enteroviruses, Lyme disease, AIDS, syphilis, etc.
4. Metabolic. The cases of its detection are not diagnosed infrequently. It causes various metabolic disorders and long-term hormonal failures.
5. 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.

Cervical disease

Refers to the most common forms. Occurs in the region of the first 7 vertebrae.

It can be caused by any of the above 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:

• Osteochondrosis;
• Scoliosis, and the like.

Congenital or acquired defects of large vessels can disrupt the functioning of the spinal cord, provoking its inflammation.

Patients with cervical myelopathy have the most pronounced and severe complaints.

They numbness 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;
• Disorientation;
• The appearance of "flies" before the eyes;
• Attacks of panic attacks and the like.

Often the symptoms of myelopathy of the cervical segment are confused with the VSD. 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.

In contrast to myelopathy of the cervical region, the patient may be disturbed by:

• Feeling of squeezing in the rib and heart;
• Heaviness on inspiration;
• Pain sensations of different 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 chest shape is very similar to the osteochondrosis of this department, although this is a fairly rare pathology of the spine.

When performing the diagnosis, it is important to differentiate it from heart disease and respiratory system.

Lumbar Localization

If the patient overtook this form of the disease, then 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.

At a compression such happens seldom, more often this system influence on a spinal cord or an organism as a whole (radiation, poisons, infections, etc.).

Symptoms of myelopathy of the cervical spine are partially observed.

Methods of diagnosis

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 report in detail:

1. How long have complaints started.
2. If he or his close relatives have chronic illnesses.
3. What kind of lifestyle does he lead (are there bad habits, etc.).
4. Was it previously exposed to radioactive irradiation 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 a survey.

Be sure to go through a general and biochemical blood test. If there is a suspicion of infection, a check of its sterility may be assigned.

In parallel, it is necessary to carry out diagnostics, including:

• X-ray;
• Electromyography;
• Electroneurography;
• 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, this can be:

• venereologist;
• oncologist;
• Vertebrologist;
• Osteopath and others.

All about the diagnosis of cervical myelopathy can tell only the attending physician.

Medication Therapy

There is no single treatment regimen. The scheme is selected individually and depends on many factors, namely:

• Causes of the disease;
• Severity;
• Age and sex of the patient;
• Accompanying pathologies and another.

For the treatment of cervical ischemic myelopathy the following groups of drugs are used:

• Vasodilators;
• Antispasmodic.

These include:

1. "But-Shpu."
2. "Drotaverine."
3. "Vinpocetine."
4. "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 long and not always successful.

If there are 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.

Operative intervention

To help the surgeon resorted to, if the myelopathy of the cervical department was provoked by mechanical factors, such as:

• Tumors;
• Cysts;
• Hernia;
• Displacement of the vertebrae, and so on.

As practice shows, the removal of benign formations in the patient has many chances to defeat the disease. Therapy for cervical myelopathy in oncology is much more difficult. As a rule, doctors do not take any predictions.

In injuries, the result may be different. It all depends on the degree of damage and localization.

Supporting Activities

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;
• physiotherapy;
• acupuncture;
• Physiotherapeutic procedures;
• Electrophoresis;
• Wearing fixing corsets;
• Visiting specialized sanatoria.

Categorically it is inadmissible to engage in independent treatment of the symptoms 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 toddlers.

Cervical myelopathy with the syndrome of ALS is observed in the majority of the patients examined. In order to slightly reduce the likelihood of its appearance, you should follow a few simple recommendations:

• Every morning start with a little warm-up;
• If the work is associated with a long sitting position, periodically get up and do various exercises, you can just be like;
• Do not slouch;
• Include in the diet meat with cartilage and dairy products;
• Get rid of bad habits;
• To refuse from 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 the 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 mood of the patient, even if the forecast is very unfavorable.