Posted by: wockhardthospitals | August 27, 2009

Sooner the better : Treat compressed spinal cords early

The spinal cord can be compressed by lesions/tumours that arise from the covering layers (dura/arachnoid) or by tumours within the spinal cord. Based on the location, they are called extradural (outside the dura), as they constitute about 80 percent of tumours, or Intradural Extramedullary (inside the dura but outside the cord)-this group amounts to about 15 percent. Intramedullary(from within the spinal cord) accounts for the remaining 5per cent.

SYMPTOMS

The symptoms of spinal cord tumour depends on the type of tumour and its location. In almost all tumours, pain is a common early feature that often precedes the on set of any neurological disturbance.

Some of the common symptoms are:

Pain in the back of neck and radiating to upper limbs or pain radiating around chest wall.

Forward or backward neck movement causing electricshock’c.,or tingling radiating down to the extremities. ! Loss or disturbance of sensation to touch/pain/heat in the upper/lower extremities or trunk.

Lower back pain ,shooting pain that runs down the legs. Distinct muscular weakness causing falls limp due to weakness in legs or difficulty in writing! doing work that involves fine movements of hand/fingers.

In the advanced stage the bladder and the bowel functions will be affected.

CAUSES

Many researchers have attributed the cause to genetic factors. In developmental! congenital disorders, it is observed that tumours generally develop from the arachnoid layer of the spinal cord or the supporting glial (non-neuronal cells that provide support and nutrition) cells.

DIAGNOSIS

The Diagnosis consists of an evaluation of the symptoms followed by a through neurological examination and then imaging by MRI/CT of the affected part based on clinical localisation.

TREATMENT

The Treatment of spinal cord tumours is far more effective when the tumour is diagnosed early. The treatment varies on the type of tumour, the location and the extent of involvement but most require surgical Excision. All spinal cord surgeries need to be done with intra operative spinal cord monitoring.

Spinal tumours that are not intramedullary can be removed completely with excellent recovery.! Intramedullary tumours may require radiation! chemotherapy after surgical excision depending on the grade of the tumour.

WHAT DOES THE DOCTOR SAY?

Early diagnosis and surgical intervention prevents irreversible spinal cord damage due to chronic pressure and hastens neurological recovery.

Consultant Dr DeshpandeV Rajkumar, neurosurgeon, WockhardtHospital

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