Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Introduction

Advances in understanding the pathophysiology of spinal cord injury (SCI) over the past 2 decades have given rise to several therapeutic strategies that are presently being examined in Phase II/I clinical trials. Furthermore, President Obama’s March 2009 decision to overturn restrictions on human embryonic stem cell research represents a new era in the field of spinal cord injuries.

Scope

*Analysis of the patient potential of spinal cord injury across the seven major markets and rest of world.

*Review of key unmet clinical needs in the treatment of spinal cord injury and current pipeline treatments.

*Identification of key opportunities and threats facing developers of treatments for spinal cord injury.

*Insight from four internationally recognized key opinion leaders in the field of spinal cord injuries.

Highlights

Therapeutic interventions for SCI need not necessarily provide a complete restoration of anatomic connections in order to lead to functional improvements and enhance patients’ quality of life. Controversy continues to surround the use of methylprednisolone as an acute treatment for SCI, indicating a need for approved neuroprotective treatments.

Alseres Pharmaceuticals’s Cethrin (a recombinant fusion protein) has demonstrated a measurable effect on neurological recovery after SCI in a Phase I/IIa clinical trial. However, with its Phase II clinical program currently on hold, future development of Cethrin is uncertain.

President Obama’s March 2009 decision to lift restrictions on US federal funding for research involving human embryonic stem cells has provided developers with a greater deal of freedom with regards to research into SCI.

Reasons to Purchase

*Quantify the incidence of spinal cord injury and identify key clinical unmet needs.

*Assess the opportunities and threats facing developers in the spinal cord injury market.

*Utilize pipeline product profiles to identify potential in-licensing opportunities.

Table of Contents :

“Overview 1
Catalyst 1
Summary 1
About Healthcare 2
About the Central Nervous System pharmaceutical analysis team 2
Executive Summary 3
Strategic scoping and focus 3
insight into the spinal cord injury market 3
Upcoming reports 5
Table of Contents 6
Chapter 1 Spinal Cord Injury: Patient Potential 7
Key findings 7
Definition of spinal cord injury 8
Classification of spinal cord injury 8
Complete versus incomplete injury 9
Tetraplegia and paraplegia 9
ASIA Impairment Scale 9
Etiology of spinal cord injury 10
Road traffic accidents are the leading cause of SCI in developed countries 11
Pathophysiology of spinal cord injury 12
Primary injury 12
Secondary injury 13
Immediate phase 13
Acute phase 13
Intermediate phase 13
Chronic phase 13
Diagnosis of spinal cord injury 14
Epidemiology of spinal cord injury 15
Seven major markets 15
New cases of spinal cord injury are expected to reach over 19,000 across the seven major markets in 2010 16
Rest of the world 18
Almost 4,000 new cases of spinal cord injury are projected each year in Russia between 2010 and 2020 20
Epidemiological trends in spinal cord injury 21
Gender: spinal cord injury predominantly affects men 21
Age: most spinal cord injuries occur in young adults although the mean age at injury is increasing 22
Mortality: life expectancies of SCI patients have increased due to advances in healthcare 24
Economic consequences of spinal cord injury 25
Chapter 2 Current Treatment Practices and Unmet Needs 27
Key findings 27
Current management of spinal cord injury 28
Surgery 28
Methylprednisolone is a pharmacological treatment option for acute spinal cord injury 29
Rehabilitation 30
Patient care path 31
The acute hospital setting is the key intervention point for neuroprotective treatments 32
For manufacturers of neurorestorative treatments, rehabilitation and community settings are key targets 32
Further opportunities exist in the management of complications of SCI 33
Unmet need in spinal cord injury 33
Neurorestorative treatments 34
Neuroprotective treatments 36
Symptomatic treatments 37
Greater efficacy of treatments for neuropathic pain 37
Treatments for autonomic dysreflexia 41
Improved treatments for spasticity 41
Chapter 3 Market Potential 43
Key findings 43
estimate of market potential 44
Spinal cord injury: opportunities and threats 44
Opportunities 45
Eligibility for orphan drug/disease status 45
Increasing R&D investment 47
Treatments can command very high price points 48
Specialized area maximizes sales and marketing force effectiveness 49
Technology applications for other conditions 50
Lifting of restrictions on human embryonic stem cell research in the US 51
Prevalence of SCI is higher than previously believed 52
Threats 53
Safety concerns with stem cell therapies 53
Potential reversal of US stem cell regulations 56
Chapter 4 Pipeline Analysis 58
Key findings 58
Clinical trial design in spinal cord injury 59
ICCP guidelines for the conduct of clinical trials in spinal cord injury 59
Spontaneous recovery and statistical power 60
Outcome measures: the ASIA impairment scale forms the standard measure 62
Inclusion and exclusion criteria 63
Clinical trial design 63
Clinical pipeline overview 64
Novartis represents the only Big Pharma company in the sparse clinical pipeline for SCI 64
The pipeline is dominated by neurorestorative treatments for acute SCI 67
Cethrin (BA-210; Alseres Pharmaceuticals) 68
Drug profile: intraoperatively administered Rho GTPase protein inhibitor 68
Development overview 69
Cethrin’s development program is currently suspended 69
Phase I/IIa trial results: Cethrin has a measurable effect on neurological recovery after SCI 70
Suspended Phase II trial 72
Product positioning 73
As the leading neuroregenerative pipeline candidate, Cethrin could be first to market 73
SWOT analysis 74
XP19986 (arbaclofen placarbil; Xenoport) 75
Drug profile: GABAb receptor agonist in Phase II development for spasticity due to SCI 75
Development overview 76
Phase II trial results: 20mg and 30mg doses show significant improvements in muscle tone 76
Product positioning 78
XP19986 will be competing with generic baclofen 78
Spasticity in SCI is expected to be the secondary indication for XP19986 79
SWOT analysis 79
ProCord (Proneuron Biotechnologies) 81
Drug profile: autologous blood-derived macrophage therapy for the treatment of acute SCI 81
Development overview 81
Phase II development of ProCord is currently on hold 81
Phase I study results demonstrate good tolerability in patients with acute SCI 83
Product positioning 85
ATI355 (reticulon 4 monoclonal antibody; Novartis AG) 85
Drug profile: first human monoclonal antibody to neutralize Nogo-A 85
Development overview 86
Phase I multicenter trial is due to be completed in Q4 2010 86
Product positioning 88
As a neuroregenerative treatment for acute SCI, ATI355 will be in competition with Cethrin and ProCord 88
Autologous Combination Stem Cell Therapy (TCA Cellular Therapy) 89
SCI represents the least advanced indication for Autologous Combination Stem Cell Therapy 89
Astrostem (RNL Bio) 89
Human clinical study of Astrostem approved by Korean FDA in April 2009 89
Neu2000 (Neurotech Pharmaceuticals) 90
Improved locomotor outcomes associated with Neu2000 in rat model of moderate SCI 90
Cordaneurin (Spinal Cord Therapeutics) 91
Cordaneurin prevents the formation of growth inhibiting scars 91
Preclinical pipeline overview 91
Spinal Cord Therapeutics and SanBio represent key developers in the preclinical SCI pipeline 93
Spinal Cord Therapeutics’s two preclinical candidates are targeting chronically injured SCI patients 93
SanBio’s two SCI preclinical candidates are allogeneic donor cell treatments 94
Initiation of world’s first human clinical trial of embryonic stem cell-based therapy is expected in Q3 2010 95
Neureva is presently seeking a co-development partner for NVA0011 (gacyclidine) 96
Discontinued pipeline candidates for spinal cord injury 96
The future of treatment in spinal cord injury 97
Key opinion leaders view partially restorative therapies to be the most likely advance in the mid-term 97
Combination treatments offer the greatest potential according to key opinion leaders 98
Geographical availability of efficacious SCI treatments will be limited by expertise of physicians and cost 99
Bibliography 101
Books and journal papers 101
Websites 112
reports 119
Appendix 120
Contributing experts 120
Conferences attended 120
Report methodology 120
About  121
About  Healthcare 121
About the Central Nervous System pharmaceutical analysis team 122
Disclaimer 124

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Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog

Illnesses of a spinal cord often lead to irreversible neurologic infringements and to proof and expressed invalidization. Insignificant on the sizes the pathological centers cause occurrence of pamplegia, paraplegia and infringements of sensitivity from top to bottom from the center as through the small area of cross-section section of a spinal cord pass practically all axifugal impellent and eisodic sensitive spending ways. Many illnesses, especially accompanied a compression of a spinal cord from the outside, carry inversive character in this connection sharp defeats of a spinal cord should be carried to the most critical urgent conditions in neurology.

The spinal cord has a segmentary structure and innervate finitenesses and a trunk. 31 pairs spinal nerves that does anatomic diagnostics concerning simple depart from it. To define localization of pathological process in a spinal cord allow border of frustration of sensitivity, paraplegia and other typical syndromes. Therefore at diseases of a spinal cord careful inspection of the patient with application of additional laboratory tests, including a nuclear magnetic resonance, computer tomography, myelography and research somatosensory the caused potentials is required. Owing to ease in carrying out and the best resolution computer tomography and the nuclear magnetic resonance supersede standard myelography. Especially valuable information on internal structure of a spinal cord gives a nuclear magnetic resonance.

Parity of an anatomic structure of a spine column and spinal cord with clinical symptoms

The universal organization of a longitudinal axis spinal cord by a somatic principle allows to identify easily reasonably the syndromes caused by defeat of a spinal cord and spinal nerves. Longitudinal localization of the pathological center establish on the uppermost border of sensitive and impellent dysfunction. In the mean time the parity between bodies of spondyles (or their superficial reference points, awned shoots) and the segments of a spinal cord located under them complicates anatomic interpretation of symptoms of diseases of a spinal cord. Syndromes of defeat of a spinal cord describe according to the involved segment, instead of a being next to spondyle.

During embryonal progresses the spinal cord grows more slowly a spine column so the spinal cord comes to an end behind of a body of the first lumbar spondyle, and its radices accept more steep descending direction to reach innervate them structures of finitenesses or internal bodies. The useful rule consists in that. That is radices (except for CVIII) leave rachial the channel through apertures above bodies of spondyles appropriating them, whereas chest and lumbar radix — under the same spondyles. The top cervical segments lay behind of bodies of spondyles with same numbers, bottom cervical — on one segment above a spondyle appropriating them, top chest — on two segments above, and bottom chest — on three. Lumbar and sacral segments of a spinal cord [(the last shape a brain cone (conusmedullaris)] are localized behind of spondyles ThIX—li. To specify propagation various extramedullary processes, especially at spondylosis, important carefully to measuresagittal diameters of the rachial channel. In norm at cervical and chest levels these parameters make 16—22 mm; at a level of spondyles li-liii-nearby 15—23 mm and below — 16—27 mm.

Clinical syndromes of diseases of a spinal cord

As the basic clinical symptoms of defeat of a spinal cord serve loss of sensitivity the border which are passing on a horizontal circle on a trunk, i.e. «A level of frustration of sensitivity», and weakness in finitenesses, innervate descending corticospinal fibres. Infringements of sensitivity, especially paresthesia, can appear in stops (or one stop) and to extend upwards, originally making impression about polyneuropathy before the constant border of frustration of sensitivity will be established. The pathological centers leading a break corticospinal and bulbospinal of ways at same level of a spinal cord, cause paraplegia or pamplegia, accompanied increase of a muscular tone and deep tendinous reflexes, and also the symptom of Babynskiy.

At detailed survey usually find out segmentary infringements, for example a strip of changes of sensitivity top level conducting touch frustration (a hyperalgesia or a hyperpathia), and also a hypotonia, an atrophy and the isolated loss deep tendinous reflexes. A level conducting frustration of sensitivity and segmentary semiology approximately specify localization cross-section affect. As an exact localizing attribute the pain felt on an average line of a back, especially at a chest level serves, the pain in interscapular areas can appear the first symptom of a compression of a spinal cord. Radicular pains points on primary localization of the spinal defeat located more lateralis. At involving the bottom department of a spinal cord — a brain cone of a pain are often marked in the bottom part of a back.

At an early stage of sharp cross-section defeat in finitenesses the hypotonia, instead of spasticity because of a so-called spinal shock can be marked. The given condition can be kept about several weeks, and it is erroneous it sometimes accept for extensive segmentary defeat, but later reflexes become high. At the sharp cross-section defeats especially caused by a heart attack, to a paralysis often precede short clonic or myoclonic movements in finitenesses. Other important symptom of cross-section defeat of the spinal cord, requiring close attention, especially at a combination with spasticity and availability of a level of sensitive frustration, vegetative dysfunction, first of all a delay serves wet.

Significant efforts are undertaken for clinical differentiation intramedullary (inside of a spinal cord) and extramedullary compression defeats, but the majority of rules are approximate and do not allow to differentiate one from others reliably. To the attributes testifying in favour of extramedullary of pathological processes, concern radicular pains; a syndrome half spinal affcets Brown-Sekar; symptoms of defeat peripheral effector neuron within the limits of one-two segments, often asymmetric; early attributes of involving of corticospinal ways; essential decrease in sensitivity in sacral segments.

On the other hand, hardly focalized the burning pains, the dissociated loss of painful sensitivity safety of sarcous-articulate sensitivity, conservation of sensitivity in the field of perineum, sacral the segments, late arising and less expressed the pyramidal semiology, normal or slightly changed structure SMZH are usually characteristic for intramedullary defeats. «Untact sacral segments» means safety of perception of painful and temperature irritations in sacral dermatome, it is usual with SIIInoSV. With rostral zones above a level of frustration of sensitivity. As a rule, it is an authentic sign the intramedullary defeats, accompanied involving of the most internal fibres spinothalamic ways, but not mentioning the most external fibres providing touch innervation sacral dermatome.

Browm-Sekar syndrome designate aggregate of symptoms half cross-section defeat of the spinal cord, shown homolateral monocles hemiplegia with loss of muscular-articulate and vibrating (deep) sensitivity a combination with contralateral loss of painful and temperature (superficial) sensitivity. The top border of frustration of painful and temperature sensitivity quite often define on 1—2 segments below a site of damage of a spinal cord as spinothalamic ways after formation synapse in a back horn pass fibres in opposite lateral funicle, rising upwards. If there are segmentary infringements in the form of radicular pains, muscular atrophies, fading tendinous reflexes they usually happen unilateral.

The pathological centers limited by the central part of a spinal cord or mentioning in basic it, mainly amaze neurocyte of grey substance and segmentary conductors, decussate at the given level. The most widespread processes such are a bruise at a spinal trauma, myelosyringosis, tumours and vascular defeats in pool of a forward spinal artery. At involving a cervical department of a spinal cord the syndrome of the central spinal defeat is accompanied by weakness of the hand significantly more expressed in comparison with weakness of a leg, and the dissociated frustration of sensitivity (analgesia, i.e loss of painful sensitivity distribution in the form of a cape on shoulders and the bottom part of a neck, without anesthesia, i.e. losses of tactile sensations, and at safety of vibrating sensitivity).

The defeats localized in the field of body C or below, squeeze the spinal nerves which are a part of a horse tail, and cause languid asymmetric paraparesis with areflexia to which dysfunction of a bladder and an intestines, as a rule, accompanies. Distribution of sensitive frustration reminds outlines of a saddle, reaches level L and corresponds to zones innervation radicular, entering in a horse tail. Achilles and knee reflexes are lowered or are absent. Pains, irradiate in perineum or a hip are often marked. At pathological processes in the field of a cone of a spinal cord of a pain are expressed more poorly, than at defeats a horse tail, and frustration of functions of an intestines and a bladder arise earlier; die away only Achilles reflexes. Compression processes can simultaneously grasp as a horse tail, and a cone and to cause the combined syndrome of defeat peripheral effector neuron with some hyperreflection and symptom of Babinskiy.

The classical syndrome of the big occipital aperture is characterized by weakness of muscles of a humeral belt and a hand after which there is a weakness homolateral legs and, finally, contralateral hands. Volumetric processes of the given localization sometimes give a suboccipital pain extending on a neck and shoulders. Other certificate of a high cervical level of defeat syndrome of Gorner which is not observed at availability of variations below segment ?II serves. Some illnesses can cause sudden «insult-like» myelopathy without previous symptoms. To their number concern a epidural haemorrhage, hemorrhachis, a heart attack of a spinal cord, an incomplete dislocation of spondyles.

Currently I am a student of First Medical University in Moscow, Russia. I am interested in all medical aspects and writing some articles. More about spinal cord illnesses and other diseases read in my blog