Spinal Cord lesions. Prepared by : Saad Al-Qahtani. Presented by : Bandar Al-Qahtani. Supervised by : Dr.Esam Al-Jamal. Anatomy . Spinal cord lies within protective covering of vertebral column. Begins just below foramen magnum of the skull. Ends opposite 2 nd lumbar vertebra.
Prepared by :
Presented by :
Supervised by :
used when conservative treatment failed.
-laminectomy (removing bone behind the spinal cord).
-foramenotomy (removing bone around the spinal nerve).
-discectomy (removing the spinal disc to relieve pressure).
Instability of the spine.
( staphylococcus is common).
(staph, Strep, E.coli, TB)
Salmonella or brucella.
-antibiotics or antimicrobial.
-may need urgent surgical decompression by laminectomy.
-extradural ( between the meninges and spine bones)
-intradural extramedullary (within meninges)
-intramedullary ( inside the cord)
Growing in epidural space
Causing collapse of vertebrae, distortion and narrowing.
e.g. lymphoma, hemangioma and neuroblastoma.
The goal of treatment is to reduce or prevent nerve damage from compression of the spinal cord, relieve pain and maintain the function.
- Surgical excisionis the treatment for extramedullary tumors.
- Radiation therapyfor intramedullary tumors.
The traditional treatment of intramedullary gliomas has been biopsy followed by radiation therapy.
Radiotherapy is clearly of value in metastatic lesions.
- Chemotherapycan be considered in patients with progression of disease after radiation therapy.
- Traumatic injury.
- Spinal cord tumors.
- Spinal stenosis.
- Ruptured disks.
- Arteriovenous malformations.
- Degenerative diseases, such as arthritis.
Symptoms vary depending on the cause of the compression, its location, severity, extent and rate of development but can include:
- Back pain at the spinal site of compression.
- Pain or burning in other parts of the body.
- Difficulty breathing.
- Weakness in the arms, legs, or both.
- Numbness or tingling in the neck, shoulder, arms, hands, or legs.
- Loss of coordination or difficulty walking.
- Loss of fine motor skills.
- Loss of sexual function.
- Loss of bladder or bowel control.
- Cervical spine disease produce Quadriplegia.
- Thoracic spine disease produce paraplegia.
- TENDON REFLEXES
- Sphincter disturbances are late feature of cervical and thoracic cord compression.
is a serious condition caused by compression of the nerves in the lower portion of the spinal canal .
is considered a surgical emergency because if left untreated it can lead to permanent loss of bowel and bladder control and paralysis of the legs.
Symptoms vary depending on the location of the injury.
Spinal cord injury causes weakness and sensory loss at and below the point of the injury.
we can divide spinal trauma into 3 levels according to its location in the spinal cord ( cervical - thoracic – Lumbosacral ).
- When spinal cord injuries occur near the neck, symptoms can affect both the arms and the legs:
- When spinal injuries occur at chest level, symptoms can affect the legs:
- When spinal injuries occur at the lower-back level, varying degrees of symptoms can affect the legs:
Rupture of the disc or prolapse as it is usually called, can press on the spinal cord and its nerve roots leading to pain, numbness and weakness and may also affect the control of bowel and urinary bladder.
Dx: X-ray, CT scan or MRI.
is a condition in which the there is a defect in a portion of the spine, causing vertebra to slip to one side of the body.
- NSAID’s (e.g. ibuprofen, COX-2 inhibitors)
- Oral steroids
- Physical therapy
- Manual manipulation (e.g. chiropractic manipulation).