Description of myelopathy of the cervical spine and its treatment. Myelopathy of the cervical spine, what to do? What is Cervical Myelopathy

In the human body, the spinal cord is an integral part of the central nervous system. This organ, located in the spinal canal, is responsible for a lot of functions, the work of vital systems. Diseases affecting the spinal cord are a serious danger, one of the most common pathologies is myelopathy.

In medical terminology, the words myelopathy of the spinal cord means a whole set of various lesions of the spinal cord. This concept combines a number of pathological processes that are accompanied by dystrophic changes.
Myelopathy is not an independent pathology. The occurrence of the disease is preceded by a number of factors, which determine which nosological form is diagnosed in a person.
In other words, myelopathy, that is, damage to the substance of the spinal cord, can be caused by injuries and all kinds of diseases, on which the name of the subsequent form of pathology depends. For clarity of thought, consider simple examples:

Ischemic - develops due to ischemia of any part of the spinal cord, that is, we are talking about a violation of blood flow.
Diabetic - occurs on the background of diabetes mellitus.
Alcoholic - its harbingers are disorders caused by severe dependence on alcohol.

By analogy, many more examples can be given. The main idea is that it is necessary to accurately determine the form of myelopathy, because the treatment being built will depend on this.
The pathological process can be subacute or chronic, but in addition to this fact and the mentioned forms of the disease, it also has more types that differ in the nature of occurrence, the nature of lesions of the spinal cord tissues, symptoms and methods of treatment.

The reasons

As mentioned earlier, the disease develops against the background of a huge number of concomitant factors. The main causes of the pathological process are other diseases or injuries of the spine:

vascular atherosclerosis;
osteoporosis;
as a result of injury;
infectious diseases;
oncology (tumors of the spinal cord);
circulatory disorders (ischemia, hemorrhages, etc.);
physiological changes in the spine (scoliosis and others);
exposure to radiation.

Given such a variety of reasons that can serve as an impetus for the development of myelopathy, we can say that both milled people and the elderly are susceptible to the disease.
In addition to the causes of the development of the pathological process, it is also possible to identify factors that predispose to the onset of the disease:

an active lifestyle with an increased risk of injury;
diseases of the cardiovascular system of various etiologies;
oncological pathologies in the body with the risk of metastasis;
professional sports;
advanced age;
spinal problems can also develop due to a sedentary lifestyle and a host of other less common factors.

Classification

According to ICD 10, the class of myelopathy diseases includes a whole group of pathological processes in which damage to the spinal cord occurs against the background of other diseases.
In the international classification of myelopathy, the code according to ICD 10 is assigned - G95.9 (unspecified disease of the spinal cord).
As for a more detailed classification of the pathological process, as mentioned earlier, spinal myelopathy is divided into many separate types. In each case, we are talking about a variety of pathology, with its own causes of development, symptoms and other conventions. To create a complete picture of the disease, consider each type of pathological process separately.

Vertebrogenic

Vertebrogenic myelopathy develops due to damage to the spinal cord of a different nature and severity. The main reason is all kinds of functional lesions of the spine, both congenital and acquired.
In most cases, the thoracic or cervical spine becomes the site of the lesion. This is explained by the increased load in these areas. Regarding what exactly leads to the development of vertebrogenic myelopathy, a number of the most common factors are distinguished:

intervertebral hernia;
the condition of the spinal cord worsens with osteochondrosis;
physical damage after blows, bruises, fractures;
any displacement of the intervertebral discs, leading to pinching;
ischemia of the vessels, provoked by their squeezing due to one of the points mentioned above.

Allocate acute and chronic forms of vertebrogenic myelopathy. In the first case, the disease develops rapidly due to severe injuries. In the second, we are talking about sluggish pathological processes that lead to the slow development of myelopathy.

spinal cord infarction

This type of disease is dangerous because an acute violation occurs in any part of the spinal cord. Therefore, it is almost impossible to predict the consequences. The cause of spinal cord infarction in most cases is a thrombus, pathology is more often observed in elderly people.
In this case, damage to the nerve fibers occurs, due to which you can lose sensitivity in certain parts of the body, in the limbs, often there is a loss of control over the muscles, and so on. In spinal cord infarction, myelopathy is accompanied by paraplegia, tetraplegia, or monoplegia.

Vascular

Vascular myelopathy is a pathological process that develops as a result of impaired blood circulation in the spinal cord. In most cases, we are talking about pathologies affecting the anterior and posterior spinal arteries.
Depending on the nature of circulatory disorders, two types of vascular myelopathy are distinguished:

Ischemic - due to partial obstruction of one or more vessels, which disrupts blood flow in a certain area of the spinal cord. In most cases, the cause is the pathology of the spine, in which the vessels are clamped.
Hemorrhagic - a more severe form of the disease, in which there is a violation of the integrity of the vessel, accompanied by hemorrhage.

cervical

It is also often referred to as discogenic spondylogenic myelopathy. This type of pathological process is more often observed in older people due to age-related changes in bone and cartilage tissue.
Myelopathy of the cervical spine occurs when the mentioned area of the spine is damaged. The main reason is the compression of the structures of the spinal cord due to the displacement of the vertebrae, the appearance of herniated discs, etc.
There is also a separate form of this type of pathology - cervical myelopathy, which is accompanied by more severe symptoms (a person may lose control of the upper limbs) and leads to disability.

Lumbar

The main difference from the previous type of disease is the place of localization. In addition, lumbar myelopathy is accompanied by completely different symptoms and complications.
In this case, the pathological process has the same causes, but the lesions concern the sensitivity of the lower extremities. In addition, dysfunction of the genitourinary system and rectum may appear.
A lesion in the region of the lumbar vertebrae threatens with loss of control over the lower extremities and paralysis.

Thoracic and thoracic

Myelopathy of the thoracic spine, as the name implies, is localized in the chest area. As for the thoracic type, we are talking about the lower part of the thoracic region. The development of the pathological process may be due to hernia, pinching or narrowing of the spinal canals.

degenerative

Degenerative myelopathy is directly related to circulatory disorders due to partial obstruction of the vessels responsible for blood circulation and feeding the spinal cord.
Among the factors contributing to the development of the described ischemia, which leads to circulatory disorders, there are mainly a deficiency of vitamins of groups E and B.
The symptoms in this case of the disease are extensive, people have disorders of motor functions, ranging from tremor of the limbs, and ending with a decrease in reflex abilities.

Compression and compression-ischemic myelopathy

These concepts unite a whole group of diseases that lead to the development of myelopathy in people of different ages.
Ischemic myelopathy is formed due to cervical spondylosis, as well as in pathologies accompanied by narrowing of the spinal canal or ischemia provoked by a neoplasm.
Compression myelopathy, as the name suggests, is caused by injuries to the spine that involve the spinal cord. These are severe injuries and fractures, disc protrusions. As well as compression, minor injuries are accompanied, in which the integrity of the blood vessels was violated.

Spondylogenic

Localization of the pathology falls on the cervical region. Myelopathy in this case is considered to be chronic. It develops due to the constant holding of the head by a person in a position that is incorrect from an anatomical point of view.
There is a syndrome of incorrect position of the head after injuries in the cervical spine, as well as in some neurological diseases.

Dyscirculatory myelopathy

Dyscirculatory myelopathy develops as a result of circulatory disorders in the cervical-brachial or anterior spinal arteries. In the first case, clinical signs are expressed in the dysfunction of the muscles of the upper extremities, while in the second case we are talking about a violation of the work of the nerve centers responsible for the sensitivity of the pelvic region. The severity of the clinical picture depends on the level of vascular damage.

Discogenic

Hernias occur between the vertebrae or their bone tissue grows. This compresses the vessels in the vertebral region and the spinal cord itself, which leads to the development of discogenic myelopathy.

Focal and secondary

When it comes to focal or secondary myelopathy, the cause is usually radiation exposure or ingestion of radioactive isotopes. This type of pathological process is characterized by special symptoms, in which the sensitivity of the skin of the hands and other parts of the body changes, the pathology is accompanied by skin rashes, ulcerations, destruction of bone tissues, etc.

Post-traumatic

The origin of this type of disease becomes clear from the name, we are talking about any injuries that affect the functions of the spinal cord. These can be blows, bruises, fractures, after which the victim is put on disability. Symptoms and consequences directly depend on the extent and level of spinal cord lesions.

Chronic

Chronic myelopathy develops for a long time, the symptoms are initially blurred, but as the pathological process progresses, it becomes more and more pronounced.
The reasons for the development of this type of pathology are extensive:

multiple sclerosis;
spondylosis;
syphilis;
infectious diseases and much more.

progressive

The cause of progressive myelopathy is a rare neurological disease in which an entire half of the spinal cord is affected - Charles Brown-Séquard syndrome.
The progression of this pathology leads to weakening or paralysis of the muscles of half of the body.

Symptoms

As you might guess from all that has been said earlier, myelopathy has a variety of symptoms, it all depends on the form and type of the pathological process. However, there are a number of common symptoms that are observed in patients in most cases:

The first symptom is always pain in the neck or any other area, depending on the location.
Also, the disease is often accompanied by an increase in body temperature up to 39 degrees of mercury.
For most people, regardless of the cause, a symptom of myelopathy is a feeling of weakness in the whole body, a feeling of weakness, general malaise.
Clinical signs are expressed in the form of dysfunction of individual parts of the body. For example, in cervical myelopathy, symptoms include muscle weakness and loss of upper limb control.
Very often, with damage to the spinal cord, there are violations of the functions of the muscles of the back.

It is impossible to describe every symptom, there are too many of them. But remember, with the slightest muscle weakness, impaired coordination of movements, systematic numbness of the limbs, which are accompanied by general symptoms, you should consult a doctor.

Diagnosis of the disease

Diagnostic measures are needed to accurately establish the causes, determine the nature and type of the pathological process, confirm the diagnosis and prescribe treatment.
Diagnostics involves the following steps:

blood tests, general, biochemical;
puncture of the cerebrospinal fluid.

Depending on the indications and suspicions, additional examinations may be required.

Therapy

Treatment of myelopathy is carried out mainly conservatively, it involves long-term drug therapy. In cases where the disease progresses rapidly or there is a threat to human life, surgical intervention is required.
For a complete and effective treatment, it is important to seek help as early as possible. As for the methods of therapy, it involves the use of such groups of drugs:

the fight against pain with the help of analgesics;
reduction of edema through the use of diuretics;
relief of muscle spasms is carried out with muscle relaxants and antispasmodics;
if necessary, prescribe vasodilators, etc.

The specificity of treatment largely depends on the causes of the development of the disease, form, type and nature. That is why it is so important to consult a doctor and undergo a full diagnosis.

The diagnosis of myelopathy refers to a pathology in which persistent damage to the spinal cord develops. Most often, the pathological process is localized in the cervical spine (cervical myelopathy), and the thoracic and lumbar regions account for about 40% of all cases.

The disease is divided into types (degenerative and post-traumatic), each of which has its own specific course and prognosis. In most cases, the prognosis for the treatment of myelopathy is conditionally favorable, but in the presence of complications or a radiation form of myelopathy, it is conditionally unfavorable.

Myelopathy is a disease that develops when the spinal cord is damaged. Moreover, we are talking not only about spinal cord injuries, the cause of myelopathy can be malignant neoplasms, circulatory diseases, inflammatory processes, and so on.

Myelopathy can be localized in any part of the spinal column. It should also be taken into account that myelopathy is an additional diagnosis to the root cause of spinal cord injury. For example, if the damage is caused by diabetes, then we are talking about diabetic myelopathy.

This disease occurs in all age groups. The traumatic type of the disease is most often observed in men aged 15 to 40 years, the tumor type is more often localized in patients aged 30 to 50 years.

Note that against the background of malignant neoplasms, the risk of developing myelopathy is in the ranges between 5 and 10 percent, while the thoracic region is most often affected (60%). Approximately 25,000 cases of tumor myelopathy are registered per year.

Reasons for development

As mentioned earlier, myelopathy is not an independent disease and develops only against the background of primary diseases that caused damage to the spinal cord.

There are the following causes of myelopathy:

Spinal cord injury (for example, with a fracture or dislocation of the vertebrae, direct back injury can also be the cause).
A herniated disc due to pressure (compression) on the spinal cord.
Osteoarthritis (spondylosis).
Malignant neoplasms (with involvement in the pathological process of the epidural space).
Infectious (including viral) and inflammatory diseases.
Violation of blood circulation in the arteries of the spinal cord (the so-called spinal stroke).
Immune reactions (autoimmune diseases in which a person's immune system attacks its own cells).
Any disease of the central nervous system that occurs with demyelination (a condition in which nerve fibers lose their myelin sheath).

What departments are striking?

Most often, myelopathy affects the lumbar spine, which is associated with frequent injuries of this area and its frequent involvement in an infectious or tumor process. This department is affected in about 60% of all cases.

This is followed by the cervical region, which is also very often prone to injury and infectious diseases. Approximately 50% of men and about 33% of women over the age of 60 suffer from spondylogenic myelopathy (it is caused by chronic diseases of the cervical spine).

The defeat of the thoracic region is relatively rare, but the specific localization of the disease does not play a special role, the disease proceeds equally severely with damage to any part of the spinal column.

However, the defeat of the cervical region carries a great danger due to the presence in this area of the vertebral arteries that feed the brain. Myelopathy itself does not affect the vertebral arteries, but the disease that caused it can. Simply put, if the causative disease has affected the spinal cord, it can also damage the vessels that feed the brain.

What is the danger?

First of all, myelopathy is dangerous for its complications. The most severe of the complications of this disease can be called partial or complete paralysis and, accordingly, disability in humans.

Another complication includes excruciating pain in those parts of the back where the pathological process takes place. In addition, with myelopathy, general neurological disorders can develop, leading to dysfunction of the pelvic organs (primary bladder and intestines).

Despite the severity of these complications, in many cases the patient's condition can be stabilized and even returned to the original. However, the prognosis of treatment is better, the sooner treatment was started, and if it is delayed, the prognosis of myelopathy is disappointing (in any of its forms).

With the development of complications, conservative therapy acts only as an additional treatment, since it can only provide temporary relief, but it does not affect the situation as a whole. The only way out in such situations is to eliminate the root cause of the disease and, if necessary, surgically restore the damaged section of the spinal cord.

Types of myelopathy

There are seven main types of myelopathy. All of them differ not only in the severity of the course and the final prognosis, but also in the clinical picture. It should be noted that regardless of the underlying cause of myelopathy, this disease is always severe and can lead to fatal consequences.

Based on the underlying cause, myelopathy is divided into the following main types:

atherosclerotic - the cause is blockage of the lumen of the spinal vessels with cholesterol (atherosclerotic) plaques;
diabetic - the cause is a complication of long-term and uncontrolled diabetes;
intoxication - the cause is a general toxic damage to the human body;
radiation - the cause is the defeat of the patient's body by radiation, in some cases the cause may be the passage of a course of chemotherapy;
inflammatory - the cause is an inflammatory process caused by infectious or other diseases;
vertebrogenic - the cause is damage to the spinal column with diseases characteristic of this organ ( spondylosis, osteochondrosis, intervertebral hernia and so on);
post-traumatic - the cause is an injury to the spinal cord or nearby organs and tissues.

Symptoms and Diagnosis

The symptoms of myelopathy resemble almost any human neurological disease. Therefore, during the initial visit to the doctor, an accurate diagnosis may not be made immediately, and a visual examination of the spinal column brings final clarity.

The symptoms of myelopathy in most cases are as follows:

Decreased muscle strength in the lower and upper limbs.
Pain of varying intensity (usually severe) in any part of the back.
Paresthesia of the skin on the arms, neck and legs.
Decreased tactile sensitivity in various parts of the body (usually in the limbs).
Bowel or bladder dysfunction.
Paralysis.
Confusion of consciousness, attacks of syncope.

Damage to the spinal cord itself or nearby organs can be detected using various methods of imaging tissues and cavities. The most effective in this case are:

Magnetic resonance imaging;
CT scan;
classical radiography.

A blood test should also be performed to exclude other, rarer causes of the development of the disease under discussion.

Treatment Methods

It may seem that, due to the complexity and severity of this disease, it is simply impossible to cure it. Fortunately, this is not the case and myelopathy can be treated quite successfully, especially if it is possible to quickly eliminate the root cause of its development.

Treatment directly depends on the etiology (cause) of the disease. For example, for the treatment of a tumor form of the disease, it is necessary to eliminate the neoplasm itself, which is quite problematic. In the post-traumatic form of myelopathy, it is enough to straighten the spinal column and prescribe painkillers to the patient.

The infectious form of the disease is treated very hard and for a long time. The damage to the spinal cord itself is the last to be dealt with, while the main treatment strategy is the elimination of infectious agents from the patient's body.

In terms of drug therapy for the treatment of spinal cord injury, the following agents are most often used:

antipyretic drugs;
vitamin complexes;
steroid drugs;
vasodilator drugs;
neuroprotective agents;
non-steroidal anti-inflammatory drugs;
various analgesics;
antioxidants.

Myelopathy - doctor's consultation (video)

Prevention

There is no clearly defined strategy for the prevention of myelopathy, which, in general, is obvious. Obviously, because it is impossible to simultaneously influence the prevention of all diseases that cause the development of myelopathy.

General recommendations for the prevention of myelopathy include minimizing back injuries and constant monitoring of the state of the body. Especially important is the annual medical examination for those people who have reached the age of 50.

With existing diseases that can cause myelopathy, it is important to monitor your own condition and constantly monitor the situation, avoiding complications.

In the presence of cardiovascular diseases, the risks of complications should be minimized by eliminating smoking, alcohol and stress. In the treatment of any infectious disease, all doctor's prescriptions should be followed, especially in terms of taking antimicrobial agents.

With the help of the information described above, the risk of developing myelopathy can be reduced, but there is no truly effective prevention of this pathology.

Symptoms of cervical myelopathy are severe pain in this part of the spine, impaired sensitivity, and movement disorders. There are several reasons for this state of affairs. Treatment may be conservative or surgical.

Collapse

What it is?

Myelopathy of the cervical spinal cord is a chronic or acute pathology that occurs due to insufficient blood flow to the spinal cord. Oxygen starvation leads to its softening and partial destruction. Myelopathy is a collective term for several diseases that present with similar symptoms and lead to destruction of the spinal cord. But their treatment is different. Depending on this, several varieties of myelopathy are distinguished.

The reasons

There are several causes of myelopathy:

Spinal cord compression. It occurs due to tumor formations in the spine, hernia, instability of the vertebrae and other factors.
Diseases of the spine. If, along with myelopathy, damage to the intervertebral disc of the cervical region is observed, it appeared due to spondylarthrosis, osteochondrosis, or other bone diseases.
Poor circulation in the spine. This condition is associated with vascular diseases (their blockage, narrowing).
Injury. It can be a bruise or a fracture, even small bumps can lead to circulatory problems.
Operation or puncture. After surgery in the cervical region, myelopathy can be one of the complications of surgery.
Inflammatory process of the spinal cord or cervical vertebrae (myelitis).

Cervical myelopathy is the most common, and its consequences are the most dangerous. Without proper treatment, the consequences of the disease can lead to disability.

Symptoms and signs

The spinal cord is very important because nerve impulses pass through it from receptors to the brain, and vice versa. And if it softens and breaks down, it can cause a number of complications. Therefore, myelopathy is accompanied by very pronounced symptoms:

Paralysis of the shoulder girdle and arms.
Very pronounced pain that does not go away even after taking medication. The pain usually worsens after exercise and sleep.
Sensitivity is impaired below the lesion. Decreased human sensations. Therefore, in the absence of treatment for cervical myelopathy, paralysis of the whole body can become a complication.
The functions of the pelvic and abdominal organs are impaired. A person may experience problems with defecation and urination, and appetite is disturbed.
General health worsens. The patient complains of drowsiness, fatigue, dizziness, sleep disturbance.
Muscle spasms of the arms and legs due to impaired transmission of nerve impulses. Coordination of movements becomes incorrect, gait changes, hand tremor appears.

If one or more symptoms occur, you should immediately consult a doctor. Otherwise, serious complications are possible.

Kinds

Myelopathy is classified according to the reasons that caused it. The following types of the disease are distinguished:

Vertebrogenic cervical myelopathy (disk). It occurs due to destructive destruction of the spine. It usually manifests itself against the background of osteochondrosis, spondylosis, vertebral instability, hernia. Discogenic myelopathy in the cervical region is the most common type of this pathology.
Ischemic myelopathy. It is the result of insufficient blood supply to the spinal cord. This can lead to: cholesterol deposits on the vessels, atherosclerosis, metabolic disorders, heart disease.
Post-traumatic pathology. It is formed due to injuries in the region of the spinal column, in which treatment was not provided on time.
Demyelinating myelopathy. This pathology is a consequence of CNS disorders that have appeared due to congenital or acquired diseases.
epidural myelopathy. It causes hemorrhage in the spinal canal. This leads to damage to the nervous tissue. If you do not start therapy, it can be completely destroyed.
Cancer myelopathy. It is associated with the occurrence of tumor neoplasms in the region of the spinal cord.
Toxic. It occurs due to irradiation of the body with cancer or due to mercury poisoning.

Cervical or cervical myelopathy requires immediate treatment, regardless of the type of pathology.

What is dangerous?

Treatment of cervical myelopathy should be started as early as possible to prevent various complications. Without therapy, the spinal cord will be too badly damaged, paralysis will occur, so control over the limbs will be lost forever. In 70-80% of cases, a neglected disease leads to disability of the patient.

Diagnostics

To diagnose the disease, you need to contact a neurologist. He may also refer you to a vertebrologist, a TB specialist, an oncologist, and a geneticist.

Diagnosis consists in identifying the disease that led to myelopathy. For this, X-ray, MRI, CT, puncture can be used. Also, the patient must pass a blood test for sterility in order to exclude the infectious nature of the disease.

Treatment

Treatment of myelopathy of the cervical spine is aimed at improving blood circulation in the affected area. Therapy can be medical or surgical.

Medical therapy

Post-traumatic myelopathy is treated with painkillers - Diclofenac, Analgin, Paracetamol. If they are ineffective, Tramadol and opiates are prescribed. The spine is stretched, after which the patient is shown bed rest. After the restoration of the affected vertebrae, a period of rehabilitation is required. During it, a special massage, exercise therapy, physiotherapy is needed.

Means are used that improve metabolism in nerve cells, which prevents the development of hypoxia. For this, drugs of different groups are used - metabolites, neuroprotectors, vitamins.

Myelopathy of an infectious nature requires the use of antibiotic, anti-inflammatory and antipyretic drugs. They eliminate the infection and relieve the inflammatory process.

With toxic pathology, it is necessary to detoxify the body. For this, special droppers that purify the blood help.

If the patient experiences very severe pain, he is shown bed rest. But the patient must perform special exercises to avoid muscle atrophy.

Operation

Cervical compression myelopathy is almost always treated with surgery. The operation is aimed at eliminating tumors, hernia, osteophytes, which lead to compression of the spinal cord in the cervical region.

A laminectomy is performed. It consists in increasing the opening through which the spinal cord passes by removing the vertebral arch. Sometimes a discectomy is required - an operation to partially or completely remove the intervertebral disc.

The prognosis for recovery is favorable, but if you see a doctor in time. The patient has a high chance of making a full recovery. But if he hesitates and self-medicates, the likelihood of recovery will decrease.

Prevention

For preventive purposes, injuries in the spine should not be allowed. It is necessary to visit doctors in a timely manner, lead a healthy lifestyle. In the presence of any diseases of the spinal column, it is necessary to carry out therapy on time. Otherwise, one of the complications may be myelopathy.

To prevent relapse, it is necessary to follow all the doctor's recommendations regarding the rehabilitation period. It is recommended to carry out self-massage of the cervical region (without strong pressure), exercise therapy. During the recovery period, physiotherapy methods are useful.

Spondylogenic cervical myelopathy is amenable to rapid treatment if it is started in a timely manner. In advanced cases, serious complications can occur. Therefore, when the first symptoms of pathology occur, you should consult a doctor.

The disorder has a somatic nature, may be associated with inflammatory processes. The basis is the destruction of nerve fibers.

It is not possible to single out the main age group of the lesion, however, the main reasons are characteristic of each age, which makes it possible to make an age classification:

enterovirus infections lead to children;
youth - spinal injuries;
middle age - neoplasms;
elderly - degenerative processes in the spine.

There are two types of impairment: progressive and chronic. In the first form, symptoms develop quickly. Most often, Brown-Séquard syndrome leads to it. Another typical example is post-traumatic myelopathy. Clinical signs: weakness in muscle tissue, paralysis, decreased sensation in the legs.

With chronic symptoms appear and increase over time. It causes syphilis, degenerative diseases, poliomyelitis.

Localization allows you to highlight the cervical, thoracic and vertebral myelopathy. The first occurs most often, accompanied by severe symptoms. Occurs in old age. It is characterized by a gradual flow.

Lumbar symptoms depend on the location of the lesion. It is manifested by weakness of the legs, pain, dysfunction of the pelvic organs, in especially severe cases - paralysis.

Signs of myelopathy of the thoracic spine are the least common. Sometimes it is confused with neoplasms or inflammation. Thoracic is often caused by a herniated disc.

The reasons

The causes of myelopathy are as follows:

inflammatory processes. First of all, it is rheumatoid arthritis, tuberculosis, spondylitis.
Injuries. When the spine is damaged, post-traumatic myelopathy develops. The main role is played by fractures of different parts of the spine. Less common is direct brain damage.
vascular disorders. Includes thrombosis, atherosclerosis, aneurysms. Vascular myelopathy develops predominantly in the elderly. In children, it is associated with congenital aneurysm.
compression syndrome. Occurs under the influence of tumors, intervertebral hernia. Compressive myelopathy of the spinal cord and blood vessels is noted, as a result of which the blood flow is disturbed. Tumors lead to a chronic process, hemorrhages or injuries lead to an acute process, hernias, metastases lead to a subacute one.

Spinal osteochondrosis is considered the leading prerequisite for the development of the disease.

Classification

A variety of reasons has allowed the development of a broad classification.

Vertebrogenic

It develops due to a violation of the spine due to congenital characteristics and acquired diseases. A herniated disc leads to acquired discogenic myelopathy. It develops mainly in men under 50 years of age.

The main mechanism of damage is compression, trauma, vascular disorders. Acute forms of myelopathy develop due to trauma, such as severe flexion of the spine. There is a displacement of the vertebrae, which leads to pinching and disruption of the conduction of nerve impulses.

Chronic is caused by osteophytes that compress the brain, nerve endings and adjacent vessels. These symptoms of myelopathy appear more often in the cervical region. The course is chronic, accompanied by moments of progression.

Pathology is manifested by muscle atrophy, first on one side, then on the other. There are painful sensations in the joints, back. Sensory disturbances increase over time. A complete injury to the spinal cord causes a disorder of sensitivity, as well as functions below the injured area.

degenerative

This species is associated with the development of degenerative diseases, such as osteochondrosis. In some cases - with a deficiency of vitamin E, B12. It appears mainly in old age.

There is a decrease in the spinal canal, destruction of the intervertebral discs. Among the main symptoms, a decrease in reflexes is distinguished. Cervical myelopathy is characterized by degenerative symptoms.

Vascular

This type is determined by circulatory disorders and vascular damage. Vascular myelopathy is associated with atherosclerosis, stroke, spinal cord infarction, thrombosis, venous congestion.

Damage to the arteries supplying the spinal cord leads to atrophy of the nerve fiber. The degree of severity of symptoms depends on the leading pathology, its causes, the age of the patient.

The most pronounced vascular myelopathy in the cervical region. Lermitte's phenomenon is called characteristic. It is distinguished by attacks of shuddering when the neck is extended, the head is tilted. Trembling starts from the neck, reaches the wrist, foot. Following trembling in the lower parts of the arms and legs, weakness is noted.

In some cases, paralysis develops. Discirculatory encephalopathy of the third degree is a typical example.

The cells located in the anterior horns have the greatest sensitivity to pathology. Due to birth defects, the disorder manifests itself at an early age. The predominant time for the development of symptoms in acquired vascular diseases is old age.

Dyscirculatory myelopathy manifests itself in Preobrazhensky and Personage-Turner disease. Preobrazhensky's syndrome is associated with paralysis, impaired sensitivity.

Post-traumatic

This type of myelopathy is caused by damage to the spinal cord. These include blows, fractures, dislocations. They lead to displacement, compression, pinching, damage to the nerve pathways and spinal vessels.

The main symptoms are paralysis, decreased sensitivity, disruption of the organs located in the pelvic region.

There is no cure for post-traumatic myelopathy.

carcinomatous

Neoplasms, metabolites, as well as substances that it produces, lead to the development of this species. Toxic substances lead to necrosis of the spinal tissue. The tumor itself compresses the tissues, leading to impaired blood supply.

It often accompanies lymphoma, leukemia, tumors located directly in the spinal cord or neighboring areas.

infectious

This type of myelopathy is associated with enterovirus infections, tuberculosis, AIDS, herpes.

Infectious myelopathy appears equally at different ages in women and men. Enteroviral is more often diagnosed in children.

The development of neurological symptoms is always preceded by the appearance of signs that are usually associated with inflammatory processes - weakness, fever, pain in the head.

Symptoms are related to the affected area. There is shortness of breath, paralysis, stool disorders.

When half of the spinal cord is damaged in cross section, Brown-Sekarovsky syndrome develops. On the side of the damage, paralysis develops, on the other - a disorder of sensitivity.

Viral, fungal inflammations lead to total damage in. There is immobilization and loss of sensation below the area of damage.

toxic

It is determined by the toxic effect on the nervous system of certain toxic substances.

It is characterized by rapid development, accompanied by violations of the motor and sensory spheres. It develops mainly at the level of the thoracic region, less often cervical myelopathy occurs.

radiation

Appears under the influence of radiation. Most often, its development is associated with radiation in the treatment of cancer of the larynx, tumors located in the mediastinum.

Allocate transient and delayed course, accompanied by an increase in symptoms. In the latter case, its appearance is noted within 6-36 months after the completion of radiation treatment.

Symptoms develop slowly, this is due to the slow atrophy of the tissues of the spinal cord. Accompanied by other symptoms of exposure - the appearance of ulcers, vesicles filled with liquid, hair loss, a decrease in bone density.

Over time, the motor functions of the lower extremities are disturbed, muscle weakness develops, their tone decreases, and sensitivity decreases. In some cases, there is a violation of the pelvic organs.

metabolic

It develops as a result of metabolic disorders, the functioning of the endocrine system. The posterior, anterior roots, anterior horns of the spinal cord are predominantly affected.

There is weakness of the feet, hands, in men - impotence. In a state of hypoglycemic coma, an increase in muscle tone, convulsive phenomena are detected.

Demyelinating

Myelopathy of this type develops against the background of multiple sclerosis or other diseases associated with demyelination of the neuronal sheath. Against the background of genetic conditioning under the influence of certain factors, the protein contained in myelin is perceived as belonging to pathogenic bacteria or viruses, and begins to break down.

It is usually accompanied by other symptoms - impaired vision, speech, swallowing.

Myelopathy of the thoracic spine is a pathological condition that occurs when the spinal cord is damaged. It can be caused by almost any reason, namely circulatory disorders, benign and malignant tumors, osteochondrosis. There are many varieties of this disease. Any of them requires the immediate start of treatment, starting with the identification and elimination of provoking factors.

What causes

The disease can affect any part of the spine, but its most common form is thoracic. Pathological conditions are classified and based on the causes of their occurrence:

Compression myelopathy is caused by spinal cord injury. With fractures and bruises, the vertebrae can move and squeeze it.

The atherosclerotic form of the disease occurs against the background of the formation of blood clots and the accumulation of cholesterol plaques in the vessels. Sometimes the provoking factor is hypertension, which disrupts the blood supply to the spinal cord. Typical signs of this type of myelopathy are the lack of sensitivity of the extremities, paresis and paralysis, speech impairment.
often affects the upper spine. In this case, a person feels weakness in the muscles and numbness of the fingers. The cause of the disease may also be an intervertebral hernia. Thoracic myelopathy is considered a fairly rare complication, because the defeat of the disks most often covers the lower back. Detection of this condition requires the use of precise medical equipment. Signs of myelopathy are often confused with manifestations of tumors.
The degenerative form develops when the blood supply to the spinal cord is disturbed. The main reason for its appearance is the lack of vitamins and minerals. - a pathological condition that is considered a complication of various diseases of the musculoskeletal system. Provoking factors include spondylosis, tumors, spinal hemorrhages, inflammatory processes, spinal injuries, protrusion of the intervertebral discs.
develops with injuries in which the patient is forced to be in an unnatural position. Discirculatory forms of pathology have a chronic course. Their characteristic signs are muscle spasms, paresthesias, or dysfunction of the chest organs. With the penetration of radioactive particles into the body or external exposure, focal myelopathy develops. Post-traumatic damage to the spinal cord can cause both a decrease in sensitivity and paralysis of the limbs. Progressive myelopathy is characterized by rapid development and the presence of pronounced symptoms.

Signs of the disease

The manifestations of thoracic myelopathy depend on the causes of its development. At the same time, general symptoms are also observed, indicating the presence of a pathological process in the body:

violation of the functions of the muscles of the corresponding part of the spine;
paresis or paralysis of the hands;
temperature rise;
fever;
pain radiating to internal organs.

If at least one of them appears, you should immediately consult a doctor.

Diagnostic measures

It implies a detailed examination. To make an accurate diagnosis and identify the cause of the development of pathology, it is necessary to undergo a series of procedures in a hospital setting. On the first day, clinical and biochemical blood tests are performed. The results obtained help the doctor determine whether the inflammatory process is taking place and whether it has an infectious origin.

The instrumental research methods used in myelopathy include:

x-ray;
fluorography;
CT and MRI;

If malignant neoplasms are suspected, a spinal cord puncture, a biopsy followed by a histological analysis, and spinal fluid inoculation are performed.

Methods of treatment

With thoracic myelopathy, not only drugs are used, but also physiotherapy procedures. Despite the danger of the disease, there are currently many ways to eliminate it. Non-steroidal anti-inflammatory and analgesic drugs help to remove. They eliminate swelling of the affected area, relieve the patient from pain. Drug therapy includes taking antibiotics and hormonal drugs.

At the next stage, physiotherapy techniques are applied. Their implementation is possible only in the absence of discomfort in the affected area. The most effective are:

massage;
acupuncture;
manual therapy;

In post-traumatic forms of myelopathy, the spine is stretched using special devices. After the vertebrae return to their normal position, they proceed to exercise therapy.

It is strictly forbidden to select exercises on your own. Their implementation requires special training and the constant presence of an instructor. Otherwise, health-threatening complications may develop.

In some cases, myelopathy is treated exclusively with surgery. During the operation, the intervertebral hernias are reduced or malignant tumors are removed. Only this will help to get rid of the provoking factor. Treatment of the disease will be more effective if the patient complies with all the instructions of the attending physician. The prognosis can only be made after the first stages of therapy.

There are causes of myelopathy, the elimination of which leads to a complete recovery of a person. These include infectious and post-traumatic inflammatory processes. However, there are also pathological processes that are considered incurable (osteoporosis). Therapy in some cases is ineffective and the patient becomes disabled.

Why is the disease dangerous?

Secondary myelopathy can lead to the development of complications such as complete paralysis of the upper limbs and disability of a person.

Severe pain and breathing problems are often observed. It is possible to normalize the work of organs. It all depends on the severity of the spinal cord injury. In chronic forms, treatment provides only temporary relief.

In order to prevent the development of myelopathy, it is necessary to lead a healthy lifestyle and eat right. There are no specific preventive measures, because the disease can be caused by various factors. There are general rules aimed at maintaining the normal functioning of the spine and internal organs:

it is necessary to monitor posture;
exercise regularly;
practice active recreation.

To prevent atherosclerotic forms of myelopathy, the principles of proper nutrition should be observed. It is necessary to refuse fatty and fried foods, alcohol.

It is recommended to sleep on a firm mattress with a proper pillow under your head. The head should not hang down or tilt back. These simple rules will help to avoid the development of not only myelopathy, but also many other pathologies of the musculoskeletal system.