Myelopathic syndrome

Myelopathic syndrome includes a symptom complex caused by damage to the membranes, substance, roots of the spinal cord due to various pathological conditions. 

[1], [2], [3], [4], [5], [6], [7], [8], [9]

Causes of the myelopathic Syndrome

Myelopathic syndrome with segmental disorders occurs when gray matter, posterior (sensitive) and anterior (motor) roots are damaged. The defeat of the segmental apparatus is accompanied by motor (paralysis and paresis), reflex, sensitive, vascular, secretory and trophic disorders.

Myelopathic syndrome with damage to the posterior cord at the level of the cervical region (tumor, trauma) is manifested by the symptom of Lermont with the head tilted anteriorly and downward the whole body pierces a sharp pain, similar to the discharge of electric current. When the posterior roots are damaged, shooting, shingles with irradiation occur at the level of the affected segment, fibrillatory and fascicular. Twitching, then the decline or loss of all kinds of sensitivity develops, paresis or flaccid paralysis develops with atony and muscle atrophy. The reflexes, the arc of which passes through the affected spine, may be weakened or lost.

When the horn of the horn is affected, pain does not usually occur, the sensitivity disorders are dissociated (pain and temperature drop out, but tactile and muscular-articular sensitivity remain), reflexes decrease or disappear. Similar disorders, but bilateral, also occur with damage to the front gray spike.

Myelopathic syndrome with segmental damage to the lateral horn is characterized by the development of autonomic reflexes with a violation of the regulation of the function of blood vessels, glands, internal organs, especially those with smooth muscles; trophic disorders with the formation of extensive bedsores (Bastian's law), sweating disorders; reflex functions of pelvic organs (Brown-Sekar symptom).

Myelopathic syndrome with conductive disorders occurs when the pathways are damaged. They are more common. In the state of paralysis, all the muscles innervated from the underlying segments are found, anesthesia is formed downwards from the level of the lesion, muscular-articular, tactile, vibration sensitivity, and a sensitive ataxia develops (gait disturbance).

The examination complex is very wide and is possible only in the conditions of a neurosurgical hospital with the involvement of a neurologist, a neuroscientist, a neurophysiologist, according to the indications - an otoneurologist.

[10], [11]

Pathogenesis

The spinal cord has a close anatomical and functional connection with the head, peripheral and autonomic nervous system, the spine, on the other hand, the metabolic, immunopathological and other processes that occur in the body affect the function of the spinal cord. Therefore myelopathic syndrome does not have a single classification. Spinal cord lesions cause disorders in the functions of its segmental and conductor apparatus.

[12], [13], [14], [15], [16], [17], [18]

Diagnostics of the myelopathic Syndrome

Topical diagnosis is complex and is the competence of neurosurgeons and neurologists (in some cases, sex therapists). The general surgeon only needs to detect myelopathic syndrome and send the patient for further examination to specialists.

[19], [20], [21]