1Spinal Cord Tumor
- 1.1Types of neoplasms
- 1.2Causes and signs of tumors
- 1.3Radicular-shell disorders
- 1.4Segmental disorders
- 1.5Conducting disorders
- 2Tumors of the spinal cord symptoms, treatment, diagnosis and prognosis
- 3Why does the tumor of the spinal cord arise and what is dangerous?
4Tumors of the spinal cord: symptoms, classification, diagnosis, treatment, rehabilitation, prognosis
- 4.1Intramedullary type
- 4.3Benign and malignant species
- 4.4Spinal neoplasms in children
- 4.5The signs of education depending on the location
- 4.7Treatment of tumors of the spinal cord
5Malignant tumors of the spinal cord
- 5.1Causes of development, classification and pathogenesis of malignant tumors of the spinal cord
- 5.2Diagnosis of malignant tumors of the spinal cord
- 5.3Treatment and prognosis for malignant tumors of the spinal cord
Spinal Cord Tumor
Currently, the tumor of the spinal cord is infrequent.
However, its occurrence is associated with the danger of late detection due to the lack of pronounced signs at the first stages of development.
For lost time neoplasm can affect adjacent tissues and organs.
Between the appearance of the first affected cells and tangible signs, even years can pass, resulting in the disease progressing and becoming difficult to cure. Therefore it is important to have information about the causes, types, symptoms of tumors and treatments for their early diagnosis and taking the necessary measures.
Types of neoplasms
The tumor can be benign and malignant in nature. With a slow or zero rate of development, one can speak of its benign appearance. In this case, the patient has a high chance of completely eliminating the disease.
The rapid growth of the changed cells with new properties transmitted to their offspring characterizes the malignant nature of the neoplasm. Tumors are divided according to the species, based on different signs: the stages of development, the place of education, the structure, etc.
Therefore, there are several classifications.
Cancer of the spinal cord can be formed directly from the brain substance or from cells, roots, membranes or vessels close to the brain. Accordingly, tumors are divided into intramedullary and extramedullary. The latter differentiate into:
- Subdural, under the rigid cerebral membrane;
- Epidural, formed over the dura mater (occurring most often);
- Subepidural, extending to both sides of the membrane.
- Perhaps you will be interested in the causes of burning in the lower back
Most often, extramedullary tumors are of a malignant nature, being fast-growing and destroying the vertebral column.
Cancer of the spinal cord can form in different spinal cord divisions or capture 2 segments at once.
So, craniospinal formations are formed, passing from the cranium to the cervical region, the tumor of the medulla cone extends to the sacral-coccygeal zone, the horse tail swelling captures 3 lumbar, 5 sacral vertebrae and coccygeal department.
- We advise you to read: horse tail syndrome
Causes and signs of tumors
The modern health care system does not specify the exact causes that lead to the formation of tumors. However, a number of risk-forming factors are singled out:
- Radiation effect on the human body;
- Poisoning of the body with harmful substances of chemical origin;
- Age (the probability of tumor formation increases with age, but it can develop at any period of life);
- Genetic predisposition, etc.
Symptoms that occur with cancer of the spinal cord are similar to those characteristic of many other diseases.
At the first stages of growth of tumors, the symptomatology may not be manifested at all.
Such properties cause the danger of late detection of neoplasm and deterioration of consequences.
- We advise you to read:sarcoma of the spine.
The first and most important sign of a tumor is the pain felt in the back area. It is characterized by a sharp, strong, frequent manifestation and is not removed with conventional medicines.
Pain sensations increase with increasing size of the tumor.
Symptomatology of tumor processes is divided into 3 complexes: radicular-shell, segmental and conductive disorders.
These symptoms of spinal cord cancer are due to tumor pressure on the nerve roots and the shell in the spinal cord.
Radicular signs are manifested in the case of damage to the spine, and depending on the force of compression and the degree of disturbance, phases of irritation or prolapse of the root can be observed.
For the stimulation phase of the spine, the pressure on it is characterized by moderate force with undisturbed blood supply.Pain sensations are present in the zone of irritation, and in neighboring zones.
When moving, touching the place of tumor formation, there are unpleasant sensations: pain, burning, tingling, numbness.
Such symptoms increase in the horizontal and decrease in the vertical position.
Closure symptoms include severe pain, increased intracranial pressure, stress in the area of tumor origin.
We advise you to read:swelling of the spine.
Segmental disorders occur when pressure is applied to certain segments of the spinal cord. At the same time, the performance of the internal organs and muscles is disrupted, and the sensitivity of the skin changes.
Spinal cord cancer affects the front, rear or side horns present in these segments. In the first case, there may be a decrease or loss of reflexes, involuntary contraction of muscles, twitching, their strength and tone decrease.
In the presence of a tumor of the spinal cord, such violations are local and occur exclusively in those muscles that are prone to injury.
Pressure on the lateral horns of individual segments of the spinal cord leads to a disruption in the supply of tissues with the necessary elements.
The temperature of the skin rises, sweating, its color may change, in some cases the skin becomes drained and flakes.
Such changes appear only in the area of affected areas.
This group consists of impaired motor activity below or above the neoplasm, and sensitivity disorders.
Intramedullary cancer of the spinal cord is characterized by a sensitivity disorder from the top down as the growth progresses (first the zone lesions, then below located areas), extramedullary - from the bottom up (begins with legs, passing into pelvic, then thoracic region, hands etc.).
A source: https://pozvonochnik.guru/opuholi/opuhol-spinnogo-mozga.html
Tumors of the spinal cord symptoms, treatment, diagnosis and prognosis
Causes and types of spinal cord tumors
Tumors of the spinal cord are observed mainly at the age of 20 to 60 years, as a rule, they are much less common than brain tumors.
Tumors of the spinal cord are divided into primary and secondary. To the primary include neoplasms emanating from the brain substance - intramedullary tumors. To secondary - extramedullary, growing from the membranes of the brain, roots and vessels.
Extramedullary tumors are subduralnymi (located under the hard shell) and epidural (located outside the brain shell). Most often they are located mainly in the thoracic region of the spinal cord, as well as in the region of the horse tail..
Intramedullary tumors are mainly represented by gliomas. Often in the spinal cord, astrocytomas and ependymomas are found. Less often - medulla-blastomas and oligodendrogliomas. Gliomas are characterized by infiltrative growth, they are usually localized in a gray matter..
Ependymomas are often found among the roots of the horse's tail.
Secondary tumors of the spinal cord sprout into the vertebral canal or are metastatic. Sources of metastases are lung cancer, breast cancer, prostate and thyroid glands.
Tumors of the spinal cord sharply disrupt the conditions of normal functioning of the spinal cord. The tumor is able to squeeze (me-ningioma, neurinoma), destroy (metastasis of cancer), and also sprout (glioma) into the spinal cord.
The tumor, developing, reduces space in the vertebral canal, this is accompanied by a disturbance of the process of liquor circulation, and tension of the meninges is also observed.
All this leads to a violation of the spinal circulation.
Macroscopically, with an extramedullary tumor, the brain looks compressed, thinned, atrophic, and with intramedullary tumor - on the contrary, thickened, as if swollen.
On the cross-section, it can be seen that the gray matter is, as it were, blurred, deformed.
When microscopic gray matter in the compressed area is observed disappearance of nerve cells, and in white matter - degeneration of nerve fibers.
Tumors of the spinal cord symptoms
For any tumors of the spinal cord, there is a syndrome of transverse damage to the spinal cord, as well as a mechanical blockade of the subarachnoid space. The clinical symptoms of the neoplasm depend on the level of location and nature of the tumor.
With extramedullary neoplasms, the syndrome of partial, and gradually and complete transverse damage to the spinal cord, as a rule, is a consequence of its compression.
With intramedullary tumors, this syndrome is a consequence of the destruction or compression of gray matter in the corresponding segment and the gradually increasing compression of the white matter of the brain from within..
The development of the syndrome of transverse damage to the spinal cord can last from several months (with malignant tumors) to 3 years (with benign neoplasms)..
The second very important symptom of the development of the tumor of the spinal cord is the growth of the blockade of the subarachnoid space. As it grows, the tumor first sharply narrows, and then sharply clogs the subarachnoid space.
As a result, the circulation of cerebrospinal fluid ceases, which leads to the development of stagnant phenomena.
Above the place where the blockade occurred, cerebrospinal fluid exerts pressure on the tumor and the adjacent parts of the brain, thereby aggravating its damage.
In the clinic of extramedullary tumors, three stages are distinguished: radicular, stage of half lesion of the spinal cord (Brown-Sekar syndrome), stage of complete transverse lesion of the spinal cord.
The earliest manifestations of the extramedullary tumor are radicular pains and paresthesias, which are caused by stimulation of the tumor. Most often, the tumors are unilateral at first, later they become bilateral, this is due to the tension of the spine on the side opposite the tumor.
With tumors in the thoracic region, these pains are shrouded in nature, with a tumor in the cervical and lumbar region of the thickening - the pain spreads longitudinally in the upper and lower extremities.
At the very beginning of the disease, the pain syndrome occurs rarely, but gradually it becomes stronger and becomes permanent. It increases with coughing, sneezing, at night - with long lying..
In the place of the affected roots, sensitivity disorders appear, and tendon skin reflexes decrease and fall out. As the tumor develops and grows, other symptoms appear that indicate a compression of the spinal cord..
If the tumor is located on the anterolateral, lateral, posterolateral surfaces of the spinal cord, then Braun-Sekar syndrome is detected - the sensitivity on the side of the tumor is broken and below it, central paresis.
But due to compression, in either case, both halves of the spinal cord are affected. At the level of tumor development, segmental disorders can occur: motor disorders - in the form of muscle atrophy, reducing reflexes; sensitive - in the form of paresthesia, radicular pain.
With further growth of the neoplasm, a clinical picture of transverse compression spinal cord - bilateral conductive sensory disorders, dysfunction of the pelvic bodies. A distinctive feature of extramedullary tumors of the spinal cord is the early manifestation and severity of the blockade of the subarachnoid space, as well as the change in the cerebrospinal fluid.
The course of intramedullary tumors is distinguished by the absence of radicular pain. The early manifestation of intramedullary neoplasms is segmental sensitivity disorders, which are dissociated.
As it grows, the tumor gradually squeezes the lateral cord of the spinal cord and there is a manifestation of bilateral motor and sensory disorders.
As a result of damage to the anterior and lateral horns of the spinal cord, bilateral peripheral paresis occurs, as well as vegetative-trophic disorders.
Blockade of subarachnoid space manifests itself much later than with extramedullary tumors. The course of intramedullary tumors is more rapid.
The clinical manifestations of spinal cord tumors at the level of different segments have their own peculiarities.
With tumors of the upper part of the neck there are pains in the neck and occiput, tension of neck muscles is observed, improper position of the head, conduction sensitivity disorders, spastic tetra-paresis.
With tumors of the cervical thickening - atrophic paresis of the upper extremities in combination with spasmodic paresis of the lower extremities, in the hands there may be a sensitivity disorder and pain..
With tumors of the spinal cord of the thoracic region, conductive sensory disorders arise, a disruption of the function of the pelvic organs, lower spastic paresis, radicular pains are shingles, thus creating a feeling of internal disease bodies..
When tumors of the upper lumbar spines are spastic paresis of the lower extremities, atrophy in their proximal parts.
Tumors of the cerebral cone are characterized by early impairment of the function of the bladder, rectum and genital organs.
In this case, paralysis of the lower limbs is absent and the tendon reflexes are preserved.
In the perineal region, a sensitivity disorder of a dissociated character is observed in the form of "rider's pants".
With tumors of the horse tail, intense radicular pain is observed with irradiation to the buttock, leg. These pains, as a rule, increase in lying position.
There are radicular disorders of sensitivity, as well as trophic disorders. Pelvic disorders appear as a delay in urine.
Tumulus of the caudal tail develops slower than the rest and can reach enormous dimensions before gross spinal disorders appear.
Tumors of the spinal cord
To establish an accurate diagnosis, the study of cerebrospinal fluid is of great importance..
When tumors of the spinal cord in the cerebrospinal fluid there is an increased protein content with normal cytosis..
With neurinoma of the horse tail and ependymoma of the end thread, the protein content is particularly high, and spontaneous coagulation in the test tube is also observed.
In order to reveal a partial or complete blockade of the s-barachnoid space, liquorodynamic tests are carried out: artificial lift cerebrospinal fluid pressure above the tumor by compressing the vessels of the neck (Quakenstedt test), tilting the head forward (Puusen's test), pressing on the abdomen (Stukey's trial). The degree and rate of pressure increase in the subarachno-idal space is determined manometrically during the lumbar puncture. The absence or insufficient increase in pressure indicates a violation of the patency of the subarachno-idal space. To completely block the subarachnoid space, a sharp drop (almost to zero) of liquor pressure is characteristic. When carrying out liquorodynamic trials, there may be a syndrome of cerebrospinal fluid Razdolsky (increased pain in the area of the affected root) and conductive paresthesia. These symptoms are of great diagnostic value, they are characteristic of tumors of the spinal cord, especially extramedullary localization.
To determine the block of the subarachnoid space and to determine the level of the tumor, contrast myelography is used.
If a tumor is suspected of a spinal cord, the patient is firstly given a radiograph of the spine in order to exclude it a disease that eventually can lead to compression of the spinal cord, as well as to identify the bone changes inherent in the spinal tumors.
The diagnosis of a spinal cord tumor is based on the presence of symptoms of progressive transverse lesion spinal cord, block of subarachnoid space, as well as characteristic changes in cerebrospinal fluid. When diagnosing, it is necessary to determine the location of the tumor, as well as its nature.
Especially important for further treatment and prognosis is the nature of the tumor - primary or secondary. The main clinical sign of the presence of metastases of malignant tumors are pain that does not disappear even at rest and in any forced position of the patient.
As a rule, metastases are localized in the spinal column. Further development of spinal symptoms occurs quickly against the background of previous severe pain.
Secondary tumors are usually always malignant, and within a year they can lead to complete transverse damage to the spinal cord.
Differential diagnosis of tumors of the spinal cord depends on the stage of the disease. It is necessary to differentiate neurinomas and meningiomas in the radicular stage from diseases of internal organs, as well as from radicular syndromes of osteochondrosis..
It is necessary to differentiate the tumors of the spinal cord with a gradual increase in the transverse lesion of the spinal cord from the spinal form of multiple sclerosis..
Differentiating in-tramadullary tumors from syringomyelia is very difficult.
With syringomyelia, spinal symptoms appear much slower, and there is also no evidence of compression of the spinal cord and changes in the cerebrospinal fluid.
From tumors of the spinal cord, primary and secondary tumors of the vertebrae, as well as those located in the vertebral canal lymphogranulomas, tuberculomas, parasitic cysts, since all these diseases are also capable of causing the dorsal compression clinic the brain.
Tumors of the spinal cord
The most radical method of treating spinal tumors is their removal. The effectiveness of surgical intervention depends on the histology of the tumor, as well as on their location.
With extramedullary benign tumors of the spinal cord, surgery is indicated at any stage of the disease. The best are surgical treatment of neurinomas and meningiomas.
The earlier an operation is performed to remove the tumor, the better will be the prognosis in terms of restoring the functions of the spinal cord.
In most cases, intramedullary tumors are inoperable. The only exception is ependymoma of the final thread.
When metastatic tumors that cause compression of the spinal cord, sometimes resort to partial removal, but only in those cases where the spinal symptomatology is the leading one.
Sometimes in tumors, positive results are obtained by radiotherapy. At some metastatic tumors resort to hormonal therapy.
Patients with compression of the spinal cord always need careful care because of the possibility of developing bedsores and an ascending urogenital infection.
Tumors of the spinal cord
The prognosis depends on the degree of tumor localization and malignancy..
Benign tumors develop very slowly (1-2 years) and after surgery for removal in most patients, work capacity is restored completely..
With intramedullary tumors, the prognosis for work capacity is much worse, complete recovery does not occur. The same is true for metastatic tumors.
With inoperability of a malignant tumor, the patient is given a group of disability indefinitely.
Patients who underwent surgery to remove a benign extramedullary tumor, even with favorable outcome of the operation is given for the time of restoration of the functions of the spinal cord for 1 year group II disability.
In the future, the issue of working capacity will be decided depending on the extent to which the restoration of the functions of the spinal cord will occur.
A source: http://www. AstroMeridian.ru/medicina/opuholi_spinnogo_mozga_psl.html
Why does the tumor of the spinal cord arise and what is dangerous?
In oncological and neurological practice, a disease such as a spinal cord tumor is common.
When untimely treatment, this pathology leads to a disruption in the function of the pelvic organs, sensory and motor disorders. The disease requires radical treatment.
Medications are ineffective. The most dangerous are malignant tumors..
The central nervous system of man is formed by the spinal cord and the brain. The first is located in the vertebral canal. The spinal cord is covered with soft, arachnoid and hard membranes..
Inside is the cerebrospinal fluid. The brain itself is formed by gray and white substances.
A tumor is a benign or malignant neoplasm that is characterized by the presence of atypical cells.
Most pathology is diagnosed in people aged 30-50 years. Sometimes tumors are found in children. In the general structure of CNS neoplasms, this variety accounts for up to 12% of cases. Most often, the tumor is located outside the spinal cord. The following structures are involved in the process:
- blood vessels;
- fatty tissue;
The following types of tumors are known:
- extramedullary and intramedullary;
- benign and malignant;
- primary and metastatic;
- subdural and epidural.
Neoplasms, which are localized under a solid cerebrospinal membrane, are less dangerous. Almost all of them are benign. The most common are meningiomas, neurinomas, lipomas, lymphomas, neurofibromas, neuroblastomas, myelomas, chondrosarcomas, gliomas.
Sometimes there is cancer of the spinal cord. It is a tumor characterized by an aggressive (malignant) course.
It gives metastases to other organs and does not respond to therapy in later stages. Intramedullary neoplasms are located in the substance of the brain.
These include astrocytomas and ependymomas. The exact causes of the disease are not established.
In the presence of a tumor of the spinal cord, symptoms are determined by its size, type and location.
In diseased people, there are radicular, conduction, and segmental syndromes. For several years, symptoms may be absent.
This is explained by the slow growth of some tumors. Compression myelopathy develops at early stages.
This is a condition in which the spinal cord is squeezed. With compression in the neck, the following symptoms are possible:
- pain of blunt character in the upper limbs, neck and head;
- impaired sensitivity (paresthesia);
- decreased muscle tone;
Sometimes there are cerebellar signs. These include gait disturbance, difficulty in movement, and tremor. Myelopathy of the thoracic region is much less developed.
With it, the muscle tone of the legs increases and sensitivity in the upper half of the trunk is disturbed..
The compression of the spinal cord in the lumbar region is manifested by pain in the buttocks and thighs..
Radicular syndrome in tumors develops in later stages. It is caused by the squeezing not of the brain but of the emerging nerves. The pain in this case has the following distinguishing features:
- increases with active movements, coughing, sneezing and straining;
- becomes more intense when lying down;
- decreases in sitting position;
- is combined with sensitivity disorders;
- stinging or shooting;
- spreads from the back to the limbs.
Some people experience a feeling of local heat. This condition is called dysesthesia. When the roots are injured, the innervation of muscles is impaired.
This can cause the curvature of the spine. With the root syndrome, symptoms of prolapse are possible.
These include reduced reflexes, paresis, and a sensitivity disorder.
For tumors, conductive disorders are characteristic. They are characterized by paresis and paralysis of the sites located below the neoplasm. If the tumor is localized outside, then there may be a Brown-Sekar syndrome.
It develops due to a half squeezing of the spinal cord. Paresis is combined with a disturbance of vibrational and muscular-articular sensitivity on the part of the lesion.
At the same time pain and temperature sensations on the other side of the body are reduced.
Sometimes neoplasms are located in the craniospinal zone. They affect the upper segments of the spinal cord and can penetrate through the large occipital foramen to the head. With malignancies of this localization, the following violations are possible:
- pain in the occiput;
- impaired sensitivity;
- central tetraparesis (restriction of movements in all four limbs);
- development of trigeminal neuralgia;
- increased intracranial pressure.
With tumors of the cervical spine, such signs as spastic tetraparesis, impaired sensitivity, shortness of breath, hiccough and a difficult cough are observed.
The appearance of the triad of Horner indicates the defeat of the C6-C7 segments.
In such patients, eye symptoms arise in the form of indentation of the eyeballs, narrowing of the pupils and ovulation of the eyelids.
When involved in the process of the lumbosacral segments, girdling pain arises. Possibly incontinence of urine and feces.
When lesions of segments S3-S5 (cone), motor disorders in the form of paresis are absent. These people have anal reflex.
The eroded clinical picture is characterized by tumors of the horse tail.
The most dangerous are malignant neoplasms. These include cancer of the spinal cord. The early sign is pain..
It is felt in the affected area, unstable, subsides at rest, increases with the progression of the disease. Sensitivity disorders are characteristic..
At first it rises, then decreases and disappears completely.
If there is cancer of the spinal cord, then the following violations are possible:
- paresis, followed by paralysis;
- muscular contractures;
- pressure sores;
- Brown-Sekar syndrome;
- pelvic disorders.
Malignant neoplasms are characterized by rapid growth and the ability to metastasize. This occurs in 4 stages of the disease.
Affected internal organs, bones and lymphatic vessels, there are signs of somatic pathology.
If there is cancer of the spinal cord, then the symptoms of intoxication in the form of weakness, subfebrile temperature and reduced efficiency. Often, the body weight decreases.
To determine the tumor in the body requires the following studies:
- radiography of all parts of the spine;
- analysis of cerebrospinal fluid;
- the definition of reflexes and sensitivity;
- lumbar puncture;
- computer or magnetic resonance imaging.
Differential diagnosis is carried out with osteochondrosis, parasitic diseases (cysticercosis, echinococcosis), radiculitis, syphilis, amyotrophic sclerosis, syringomyelia, aneurysm, myelitis. A similar clinical picture is observed when the spinal vessels are affected.
If there is a suspicion of a secondary (metastatic) tumor, you need to identify the primary focus.
The main and most effective method of treating patients with a spinal cord tumor is surgery. Irradiation and chemotherapy are auxiliary methods.
If necessary, the spinal canal expands. This manipulation is called a laminectomy.
It is required in the presence of meningioma and neurinoma. Surgical intervention with intracerebral tumors is difficult. Often it leads to structural damage and complications.
Most malignant tumors are characterized by infiltrative growth. In this case, the operation is impossible. Treat these people with radiotherapy and chemotherapy.
They can reduce the tumor and eliminate the symptoms of compression.
If the operation is impossible and the very pain is disturbed, then the cutting of the root can be performed..
The prognosis for timely treatment of extramedullary neoplasms of a benign character is usually favorable..
With cancer of the spinal cord, symptoms appear already in the late stages. In this case, the percentage of five-year survival is low.
A source: http://spina-health.ru/opuxol-spinnogo-mozga/
Tumors of the spinal cord: symptoms, classification, diagnosis, treatment, rehabilitation, prognosis
Almost 15% of all CNS formations are tumors of the spinal cord. They are in the same amount found in representatives of both sexes, are more often detected at the age of 20 to 60 years.
Education is benign and malignant. Sometimes, in the early stages, they go unnoticed, because they "masquerade" for other ailments.
Tumors of the spinal cord are divided into primary and secondary. The latter arise in the spine and quickly begin to give metastases to the thoracic and peritoneal region.
All species are localized at different levels, but the thoracic section is the most susceptible to their appearance. The least they are found in the lower, that is, the lumbar spine.
Tumors of the spinal cord are subdivided by localization of origin, histological features.
By localization are:
- extramedullary (subdural, epidural, mixed).
- primary (neurinoma, meningioma ...),
- secondary (chordoma, hemangioma ...).
Types of spinal cord tumors in the picture
According to histological features:
- nervous tissue,
- the meninges,
- connective tissue,
- adipose tissue.
This species arises from the substance of the spinal cord. He is one of the rare.
It differs in its benign character, its slow growth. They are mainly represented by gliomas. Such tumors are manifested by a decrease in sensitivity on the affected area.
This species is divided into an extra-cerebral, emanating from the mild cervical membrane, emanating from the brain tissue. In the intradural region, there are formations of blastomatous or inflammatory origin. The latter include various cysts formed after meningitis, tuberculoma.
This type of tumor of the spinal cord appears in anatomical formations: rootlets, membranes, vessels. With it, there is a gradual loss of sensitivity in the lower limbs.
Most of the formations are primarily malignant cells, metastases..
The tumor first squeezes subarachnoid space, blood vessels. Only then does the spinal cord turn on. Violation of blood circulation extends to all the lower divisions..
Due to the pathological process, a large amount of protein and erythrocytes enter the cerebrospinal fluid.
Benign and malignant species
Benign and malignant spinal tumors threaten life, so treatment is mandatory.
The first kind can strike nerves, therefore leads to strong pains, neurological disorders.
Despite its slow growth in the denial of medical intervention, paralysis may occur. Such formation can be transformed into malignant.
Cancer in 2/3 of the cases gives metastases to the spinal cord of the lymph, lungs and mammary glands.
For this species is characterized by a violation of sensitivity, motor functions. Pelvic organs also cease to perform their functions properly. In contrast to benign, this type is characterized by rapid growth and progression.
At the initial stages of cancer, a temporary cessation of the work of nerve cells occurs, but their integrity is not violated. The more time passes, the faster the reversible processes change to irreversible. All fibers in the lesion are degenerated.
Spinal neoplasms in children
Primary tumors of the spinal cord in children are rare, but they have many difficulties in treatment.The most frequent are:
In children, the spine continues to grow, so the doctor appoints a special treatment and appoints procedures, aimed at preserving neurological functions and postoperative stability post.
The causes of the appearance of formations in the spinal cord in children have not been established to this day. It was revealed that they are more often found in those who were exposed to radiation. Sometimes in infants such a disease is genetically determined..
In 20% of the tumor is congenital in nature, but with benign flow until the appearance and formation can take many years. The child begins to complain of pain in the arms and legs, there is a protrusion in the spine..
The first sign is pain at the site of the lesion. Usually it appears with sudden movements.
The more education becomes, the more such feelings become more pronounced. Sometimes at first there is a violation of sensitivity, the appearance of weakness, rapid fatigue when walking.
With extracerebral formations appears radicular-shell syndrome. At this time, the pain intensifies in a horizontal position.
Significantly, it decreases with the vertical position. With neurinomas discomfort occurs when pressure on the jugular veins. This leads to an increase in intracranial pressure.
Intracerebral tumors are devoid of staging, but in the first stages there are signs of damage to individual segments of the spinal cord. This leads to muscle twitching, sensitivity disturbance.
The signs of education depending on the location
If the cervical region is affected, then the pain gives to the nape, movements of the neck become very painful. Over time, there is a violation of breathing.
With cancer of the spinal cord in the thoracic region, pain occurs between the ribs. There is a violation of cardiac activity.
If the tumor is formed in the lower sternal segments, then the symptomatology begins to resemble pancreatitis, appendicitis..
When the level of lumbar thickening is affected, paraparesis develops, muscle atrophy develops. A decrease in knee reflexes is noted, while Achilles increase..
Formations in the region of the horse tail are manifested by severe pain in the sacrum, legs. They become especially unbearable at night.
Examination of the tumor of the spinal cord is carried out in a hospital. First, neurological examination and electromyography are prescribed. The latter allows estimating the bioelectric activity of muscles.
Informative methods are:
- MRI and CT, conducted with intravenous contrast. They can accurately determine the place where the education appeared.
- Radionuclide diagnostics. In this case, radiopharmaceuticals are introduced. They are differently heated in formations and healthy tissues.
- Spinal puncture and taking liquor. They allow us to identify conduction abnormalities, to reveal the place of the tumor. The higher the protein level, the lower the formation.
MRI picture of a ring-shaped tumor of the spinal cord
Many patients are prescribed spondylography, which makes it possible to differentiate the ailment from other causes of compression of the spinal cord. This is an x-ray study that allows you to obtain information about the condition of the vertebrae, intervertebral discs.
Treatment of tumors of the spinal cord
Absolute indications for surgical intervention are any tumors of the spinal cord that exert a compression effect.
Also, the operation is indicated with a sharp pain syndrome.At early diagnostics, and also at a benign character complete recovery is possible.
It is not justified to treat only with multiple metastases. If the formation is large or is inaccessible, then it is excised as much as possible. If cancer is detected, surgical treatment is accompanied by radiation and chemotherapy.
After the removal of the tumor of the spinal cord medications are prescribed, which restore the blood supply in the spinal cord.
Necessarily appointed LFK, which depends on the localization, massage of the limbs.
While the patient is in a recumbent position, it is necessary to conduct hygienic procedures and use special mattresses to avoid the occurrence of pressure sores.
After discharge from the hospital it is important to continue treatment activities. Many learn to walk anew using special walkers. All patients need to carry out activities that are developed on the basis of an individual program.
Good results can be achieved with moderate manifestations of pelvic and motor disorders.
It depends on the degree of neurological disorders at the time of seeking medical help.
With the timely removal of extramedullary structures of a benign nature in 70% of cases, a full recovery occurs. It can take from 2 months to 2 years. If the compression lasted more than 12 months, the patient receives a disability because of the impossibility of complete recovery.
With intramedullary formations, the prognosis is worse, since usually the operation allows only to improve the condition. With inoperable formations, the patient is given an unlimited 1 group of disability..
This video tells about the clinic and diagnosis of tumors of the spinal cord:.
A source: http://gidmed.com/onkologiya/lokalizatsiya-opuholej/spinnoj-i-golovnoj-mozg/opuholi-spinnogo-mozga.html
Malignant tumors of the spinal cord
Malignant tumors of the spinal cord- neoplasms of various origin located in the region of the spinal canal. The development of tumors is accompanied by a progressive wave-like increase in clinical symptoms caused by compression of the nervous tissue.
There are pains, impaired sensory and motor functions and disorders of pelvic organs. The diagnosis is based on symptoms, examination data, MRI results, radiography, spinal puncture and other studies.
Surgical treatment followed by radiotherapy.
Malignant tumors of the spinal cord are a diverse group of neoplasms emanating from one's own substance, membranes or roots of the spinal cord. They differ from benign tumors of the same localization with aggressive growth and rapid progression.
Do not form distant metastases, dissemination occurs over liquor spaces. There are 9 times less brain tumors. They can occur at any age, but are usually diagnosed in patients 30-55 years of age.
In men, the probability of developing a malignant tumor of the spinal cord is slightly higher than that of women. Clinical symptoms are determined by the level of the lesion, the ratio of the neoplasm to the substance and the membranes of the brain and its attachment to one or another surface of the spinal cord.
The treatment is carried out by specialists in the field of oncology, neurology and neurosurgery.
Causes of development, classification and pathogenesis of malignant tumors of the spinal cord
The causes of this pathology have not been fully elucidated.
Among possible risk factors, oncologists indicate an increased level of radiation, an unfavorable ecological environment, contact with some toxic chemicals, traumatic injuries and hereditary predisposition.
Depending on the localization of the primary process, primary (derived from the brain substance and surrounding tissues) and secondary (resulting from distant metastasis) malignant tumors of the spinal cord.
With regard to origin, intramedullary tumors formed from brain matter and extramedullary tumors developed from roots or membranes are distinguished.
Intramedullary neoplasms are localized inside the spinal cord, extramedullary - outside of it.
Extramedullary tumors are divided into subdural (located under the cerebral membrane) and epidural (localized above the meninge).
Most malignant tumors of the spinal cord are metastatic. Most often metastasizes breast cancer, lung cancer and lymphoma. The origin of primary neoplasms can differ.
Pathologically proliferating and mutating cells of connective tissue (tendons, ligaments and solid structures) give rise to extradural sarcomas, cells of the medulla - intradural meningiomas, cells of nerve roots - intradural neurofibromas, neuroglial cells - intramedullary astrocytomas, cells lining the spinal canal - epindiomas. Most of the listed neoplasms can be both benign and malignant..
Clinical symptoms of malignant tumors of the spinal cord are caused by compression of the nerve tissues. At the initial stages, the phenomenon of parabiosis (temporary cessation of the functioning of nerve cells while maintaining their structural integrity)..
With the progression of the process, the structure of cells is increasingly disrupted, reversible changes are replaced by irreversible ones. Nerve fibers located at the level of the neoplasm and below the tumor are subjected to Waller degeneration.
The defeat of nerve cells is exacerbated by the compression of blood vessels and disorders of the local circulation.
With all neoplasms, there is an increasing wave-like disruption of the functions of the spinal cord. The first sign of the disease is usually pain in the affected area.
In the initial stages, the pain is unstable, provoked by sharp movements (turns, inclinations), coughing or straining.
As the progression of the malignant tumor of the spinal cord increases, the pain syndrome increases, the pains become diffuse and persistent.
Disturbances of sensitivity initially manifested by hyperesthesia, then - hypesthesia, and in the subsequent - anesthesia.
Sometimes, first there are disorders of sensitivity and motor functions, and then pain symptoms join to these symptoms. The nature of conduction disorders depends on the type of malignant tumor of the spinal cord.
With intramedullary neoplasms, two-sided conduction disorders are revealed, manifested as central paraparesis or tetraparesis. The patient feels weakness in the extremities, quickly gets tired while walking.
There are not very pronounced violations of the function of the pelvic organs, gradually replaced by gross pelvic disorders..
The extinction of tactile, pain, proprioceptive and other types of sensitivity is observed. Over time, complete anesthesia. Paresis is replaced by paralysis, accompanied by marked spastic phenomena..
Contractures are quickly formed. Bedsores are formed.
With extramedullary malignant tumors of the spinal cord, a unilateral radicular syndrome develops, to which the phenomena of compression myelopathy subsequently join.
The features of the symptomatology are determined by the location of the neoplasm in relation to the surfaces of the spinal cord.
With localization in the side, especially in the case of an intramedullary tumor, the development of the Brown-Sekar syndrome (occurrence of motor disorders on the side of a malignant tumor of the spinal cord and sensitivity disorders - on opposite).
With neoplasms located on the anterior or posterior surface of the spinal cord, symmetrical neurological disorders usually appear.
The dynamics of the spread of motor disorders and sensitivity disorders in intramedullary and extramedullary malignant tumors of the spinal cord also differs.
For extramedullary neoplasms, ascending disorders (movement and sensitivity disorders arise in the distal parts of the limbs, and then extend proximally), for intramedullary - descending. With extramedullary tumors, it is possible to maintain sensitivity in the perineal zone, with Intramedullary neoplasms, sensitivity in this area is disrupted on a par with other affected areas.
A specific manifestation of benign and malignant tumors of the spinal cord is the constriction and subsequent blockade of the subarachnoid space..
To confirm the blockade, an X-ray contrast test or a lumbar puncture with liquorodynamic samples is performed. Clinical evidence is supported by the results of the CSF study. Cell-protein dissociation is revealed..
Hyperproteinarchy is directly proportional to the degree of blockade. A greenish-yellow color of the liquor is possible.
Focal symptomatology is determined by the localization of the neoplasm. With tumors in the region of the upper cervical vertebrae, spasmodic tetraplegia develops. Patients are concerned about pain in the neck and shoulder straps.
With neoplasms at the level of the lower cervical and first thoracic vertebrae, flaccid paralysis of the upper extremities and spastic - lower ones is revealed. Pelvic disorders usually appear in the late stages.
For malignant tumors of the spinal cord located in the thoracic region, characteristic girdling pains, spastic paralysis of the lower extremities, incontinence of urine and feces.
In tumors in the lumbar region, paralysis (usually flaccid, less often spastic) and early disorders of pelvic organs are observed.
Neoplasms in the region of the sacrum are manifested by pains on the back surface of the limbs, paralysis of flexor muscles, gross pelvic disorders and early extensive bedsores in the sacrum.
Tumors of the horse tail are accompanied by severe pain in the legs, early loss of reflexes, late development of paralysis, delayed urination and frequent bedsores. The nature of the disturbance of sensitivity in all cases corresponds to the level of damage.
Diagnosis of malignant tumors of the spinal cord
The diagnosis is established taking into account complaints and anamnesis of the disease, general and neurological examination data and results of instrumental studies.
The classical diagnostic technique is the radiography of the spine, however this method is not informative in the early stages of the disease, since it does not allow to detect changes in soft tissues.
In the advanced stages on radiographs, the destruction or displacement of the vertebrae is determined..
More reliable results allow to obtain lumbar puncture with special probes and subsequent investigation of cerebrospinal fluid. With a positive Kwiecenstedt test, the pressure of the CSF during pressure on the jugular veins does not change..
With the location of a malignant tumor of the spinal cord in the puncture zone, the cerebrospinal fluid does not flow. There is pain caused by the stimulation of the neoplasm with a puncture needle. Investigation of CSF confirms the increase in the amount of protein.
Tumor cells in the cerebrospinal fluid are very rare.
The most informative method of investigation is the MRI of the spine, which allows one to evaluate the localization and the size of a malignant tumor of the spinal cord, its relation to various soft-tissue and bone structures.
If the MRI is unavailable, the patient is referred for contrast myelography, with which it is possible to determine the type (extramedullary or intramedullary) and the level of the tumor location.
Pneumoviligraphy and isotope myelography are almost never used because of the high risk of complications.
The diagnosis is confirmed on the basis of the results of a histological examination of the tumor samples obtained during the surgical intervention.
Treatment and prognosis for malignant tumors of the spinal cord
Treatment of malignant tumors of the spinal cord is an extremely difficult task. Radical surgery for tumors of the spinal cord in most cases is impossible due to the germination of surrounding tissues.
The tactics of treatment are determined taking into account clinical manifestations. Patients are prescribed radiotherapy and chemotherapy.
With a mild compression, corticosteroids are used to reduce inflammatory reactions and reduce pressure on the nerve tissue..
With coarse compression of the spinal cord, surgical decompression is performed by partial removal of the intramedullary tumor or excision of the extramedullary neoplasm..
With intensive pain, surgery is performed to cut the spinal-thalamic path or the nerve root. The prognosis for malignant tumors of the spinal cord is unfavorable.
Complete recovery in most cases is impossible. The treatment is palliative, aimed at reducing symptoms and improving the quality of life of patients.
Life expectancy is determined by the type and degree of malignancy of the tumor, the effectiveness of chemotherapy and radiation therapy.
A source: http://www.krasotaimedicina.ru/diseases/oncologic/malignant-spinal-tumors