Diseases of the spinal cord

Abstract

Pathology associated with spinal cord lesions is common in medical practice and can vary in nature — from birth defects to injuries, inflammatory and vascular diseases, tumors and degenerative dystrophic processes. The purpose of our lecture was to describe the etiopathogenetic mechanisms of spinal cord diseases, diagnosis, clinical picture and treatment, including emergency medical care. Among the birth defects of the spinal cord, a special place belongs to Chiari malformation — a downward displacement of cerebellar tonsils below the level of the foramen magnum. Often this anomaly is combined with hydrocephalus or syringomyelia. Describing pathology such as spina bifida, it is determined that it is associated with the anomaly of the posterior neural arch development with posterior arches not fused, and is often associated with dermoid cysts and lipomas. Such pathology as diastematomyelia is a splitting of the spinal cord with a bone or fibrous septum, and platybasia is caused by displacement of the posterior cranial fossa and invagination of the C2 odontoid process into the space of the posterior cranial fossa, which can be clinically manifested by spastic tetraparesis. Syringomyelia was also described, which is accompanied by the formation of cavities filled with cerebrospinal fluid in the cervical or thoracic spinal cord and may cause dissociative disorders of sensation. The section of acute traumatic injuries of the spinal cord presents their classification and describes concussion, contusion and compression of the spinal cord, symptoms that accompany these lesions, and methods of diagnosis, treatment and rehabilitation. An important section of the lecture is devoted to ischemic and hemorrhagic types of acute and chronic disorders of the spinal blood circulation. Data on the etiology, clinical picture and current approaches to the treatment of transient disorders of the spinal circulation are also presented. Consideration is given to the problem of amyotrophic lateral sclerosis, which is often accompanied by lesions of spinal and brainstem motor neurons. This pathology is progressing rapidly and may lead to respiratory weakness and failure.