The diagnosis of acute treatment of spinal cord compression

By | April 12, 2012

The diagnosis of acute treatment of spinal cord compression, brain metastasis from primary and secondary intracranial tumors are often caused by central nervous system lesions can be seen. Common clinical manifestations of intracranial hypertension in acute pain and the formation of the brain, two types of acute spinal cord compression.
Acute spinal cord compression spinal cord and nerve root compression in tumors and metastatic spinal epidural metastasis occurs when the compression fracture, about 5% of cancer patients hair.
1. Etiology: 95% of metastatic tumors, a common primary tumors were breast cancer, malignant lymphoma, multiple myeloma, sarcoma, prostate cancer, kidney cancer, and so on. About 8% of the patients in the unknown primary tumor prior to spinal cord compression as the first form.
2. Clinical manifestations
(1) local pain and belted a sense: Most patients with intermittent pain in the beginning, and later gradually increase was sustained, supine increased about 1-4 weeks a corresponding segment of the belted sense.
(2) paresthesia: about 57% of the patients began to feel there may be allergic to the later emergence feeling diminish or disappear.
(3) weakness and muscle weakness: about 76%, and a clear positioning of. About 15% of patients, led to paralysis patients, 10% of patients may later occur.
(4) bowel and bladder dysfunction: About half of the patients when the diagnosis of spinal metastasis have bladder and gastrointestinal dysfunction.
The diagnosis of acute treatment of spinal cord compression 3. Diagnosis and differential diagnosis
(1) According to the symptoms, signs, neurological basis of examination to determine the positioning of the spinal cord segment of nerve damage.
(2) spine radiography: The positive rate of about 8%; about 17% of cases, many parts of the spine were involved.
(3) a thin layer of spinal CT examination can be found in smaller lesions. MRI is a more appropriate understanding of intradural or outside, inside or outside the spinal canal and vertebral lesions involved the situation.
(4) radionuclide bone scan: positive rate than the X-ray film can be found in 1-3 months ahead of pathological lesions. About 20% of the X-ray examination may be negative after this examination revealed abnormal lesions.
(5) myelography: This method is the diagnosis of spinal cord and nerve root compression syndrome means the most valuable, both to determine the tumor size and location of the site, but also identify the epidural or intradural pressure, osteolytic or osteoblastic of bone damage caused by primary tumors or metastatic tumors; as surgery or radiotherapy can provide accurate location.
4. Treatment: Once diagnosed, emergency treatment must be as a tumor in order to avoid or reduce the irreversible changes in neural function.
(1) glucocorticoids: dexamethasone 10mg IV, later changed to 4-5mg, every 6h1 times, can quickly reduce pain and improve nervous system function.
(2) radiation therapy: the effect of radiotherapy treatment time and sooner or later and with a large radiation dose related. It was suggested that use of corticosteroids before radiotherapy 3 days than the beginning of radiotherapy to reduce the radiation dose to increase the initial symptoms of increased even more valuable. About half of the patients had neurological symptoms after radiotherapy for port reform speech
(3) surgery: laminectomy or corpectomy aim for a quick lifting of spinal cord compression, relieve pain, provide opportunities for future treatment.
(4) systemic chemotherapy: only the sensitive tumors, can be used as a means of effective treatment and other alternative treatment.
The diagnosis of acute spinal cord compression therapy, in short, radiotherapy is still the first choice for treatment of spinal cord compression method. Surgery, radiotherapy, chemotherapy and corticosteroids, dehydrating agent applications, coupled with the promotion of neurotrophic drugs, immune agents, and other methods of Chinese medicine can improve the efficacy of combined treatment and prolong patient survival.

Leave a Reply

Your email address will not be published. Required fields are marked *