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Emergency radiation therapy (usually 20 grays in 5 fractions, 30 grays in 10 fractions or 8 grays in 1 fraction) is the mainstay of treatment for malignant spinal cord compression. It is very effective as pain control and local disease control.
The body is innervated by spinal nerves that branch off from the spinal cord. [18] This innervation enables the brain to receive sensory inputs and send motor outputs. There are 8 cervical spinal nerves of the peripheral nervous system. Cervical spinal nerves C1, C2 and C3 help control the movements of the head and neck.
Rheumatoid arthritis Those affected with rheumatoid arthritis in their cervical spine are known to have neurological deficits. It results in occipital pain and myelopathy. [5] Occipito-cervical junction This disorder may result from rheumatoid arthritis, causing the hypermobility of the connection between the neck and head, resulting in ...
The most common form of myelopathy in humans, cervical spondylotic myelopathy (CSM), [2] [3] also called degenerative cervical myelopathy, [4] results from narrowing of the spinal canal (spinal stenosis) ultimately causing compression of the spinal cord. [5] When due to trauma, myelopathy is known as (acute) spinal cord injury.
Central cord syndrome (CCS) is the most common form of cervical spinal cord injury (SCI). It is characterized by loss of power and sensation in arms and hands. It usually results from trauma which causes damage to the neck, leading to major injury to the central corticospinal tract of the spinal cord. [1]
In cervical spondylosis, a patient may be presented with dull neck pain with neck stiffness in the initial stages of the disease. As the disease progresses, symptoms related to radiculopathy (due to compression of exiting spinal nerve by narrowed intervertebral foramen) or myelopathy (due to compression on the spinal cord) can occur. [2]
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. [6] Symptoms may include pain, numbness, or weakness in the arms or legs. [1] Symptoms are typically gradual in onset and improve with leaning forward. [1]
The MILD procedure aims to relieve spinal cord compression by percutaneous removal of portions of the ligamentum flavum and lamina. [10] Laminectomy also involves partial or complete removal and sacrifice of the lamina, but in addition, facets in one or more segments of the spinal cord are usually sacrificed as well.