Spinal cord disorders refer to a broad group of acquired or genetic conditions that cause injury, deformation or reduced function of the spinal cord. The spinal cord is the primary conduit of brain signals throughout the body and is instrumental in controlling virtually every function below the neck. It is also a relatively fragile structure that is susceptible to damage from a multitude of potential issues. The symptoms of a spinal cord disorder will largely depend on where the spine experiences the problem. These symptoms are, for the most part, very predictable. In fact, a precise location in the spine can often be determined by a simple physical examination and analysis of symptoms.
The main causes of spinal cord disorders are:
- Spine Tumors
- Degenerative disc disease
- Vertebral compression fractures
- Vertebral instability
- Herniated discs
- Lumbar stenosis
- Back and neck pain
- Spinal cord injury
The conditions above can be congenital or acquired, and may be caused by trauma, infection, or compression due to benign or malignant tumors, herniated discs or the accumulation of fluid such as blood or pus (infection).
Symptoms and Diagnosis of Spinal Cord Disorders
Symptoms of spinal cord disorders will vary based on the type of disorder and what part of the spine it affects. The spine has four parts, from top to bottom – Cervical (neck), Thoracic (chest), Lumbar (low back) and Sacral (pelvis). Each of these sections affects function in different parts of the body. Some of the most common symptoms of spinal cord disorders include:
- Pain, which may be localized or widespread, depending on the structures and nerves involved
- Loss of sensation and, in some cases, paralysis
- Loss of urine or bowel control
- Sexual dysfunction
- Deformity that may cause mild or severe posture problems
The degree to which these symptoms affect the patient also depend on the location and severity of the injury, infection or compression. Some loss of function may be partial and temporary, while in other cases it may be extensive and permanent.
The diagnosis of spinal cord disorders is often apparent upon evaluation of medical history and presenting symptoms. However, diagnostic imaging will often be used to determine the exact cause and location of the disorder and assist in the creation of a treatment plan. Magnetic Resonance Imaging (MRI) is the most accurate form of diagnostic testing as it relates to the spine, while myelography with computed tomography (CT) may be employed in cases where an MRI is not possible or advisable (i.e. patients with certain implanted medical devices).
Treatment for Spinal Cord Disorders
The sooner a spinal cord disorder is identified and treated, the greater the likelihood for partial or full recovery. Ultimately, the goal is to prevent the worsening of the disorder and subsequent symptoms. Therefore, the medical team may employ one or more of the following therapies:
- Because of the severity of spinal cord infections and limited blood supply to the spinal cord, antibiotic treatment is often required for up to 8 weeks, combined with bracing and bed rest. Antibiotic treatments are general delivered via IV.
- Surgical treatment can be used to treat infection and injury, including compression disorders and chronic pain, and can be employed to reverse or prevent the worsening of spinal deformities.
- Rehabilitation will almost certainly be necessary after a significant event involving the spine. This may include physical therapy to improve coordination and muscle tone, as well as occupational therapy that gives patients options to manage loss of function.
In cases of total paralysis, curative treatment may not be possible. As such, skilled nursing and long-term care may be employed to maintain patient safety and keep the patient as comfortable as possible. Emotional support is critically important for patients that have lost most of their bodily functions.
Neurosurgeons and orthopaedic surgeons collaborate to provide the most advanced techniques for delicate spinal surgery. One of the latest procedures to be offered is percutaneous vertebroplasty, a minimally invasive technique that involves injecting a plastic-like substance into the site of vertebral compression fractures caused by osteoporosis or bone cancer to relieve pain and aid in healing.