Spinal cord and roots

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Disorders localised to the spinal cord or nerve roots are detailed below, but note that many diffuse neurological disease processes also affect the cord (see Section V, e.g. multiple sclerosis, Friedreich's ataxia).

SPINAL CORD AND ROOT COMPRESSION

As the spinal canal is a rigidly enclosed cavity, an expanding disease process will eventually cause cord and/or root compression.

Causes tumours primary • secondary

. extradural intradural (extramedullar) intramedullary infection —— acute, e.g. staphylococcal^__ extradural chronic - TB intradural disc disease and spondylosis

haematoma — spontaneous trauma extradural intradural intramedullary extradural cystic lesions intradural - arachnoidal

^ intramedullary - syringomyelia

Manifestations of cord or root compression depend upon the following:

Site of lesion within the spinal canal:

an expanding lesion outside the cord produces signs and symptoms from root and segmental damage.

root — lower motor neuron (l.m.n.) and sensory impairment appropriate to the distribution of the damaged root. segmental —- l.m.n. and sensory impairment appropriate to segmental level. Interruption of ascending sensory and descending motor tracts produces sensory impairment and an upper motor neuron (u.m.n.) deficit below the level of the lesion.

Lesions within the cord (intramedullary) produce only segmental signs and symptoms.

Root damage

Root damage

Segmental damage

Interruption of descending motor tracts

Segmental damage s Ingl Interruption of

___ascending sensory

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