Spinal cord and spine congenital defects (spina bifida)
Great importance in the development of spine diseases some kind of abnormal development (congenital defects) or acquired changes in the spine. To congenital anomalies of the spine include: Klippel–Feil syndrome, cervical rib, spina bifida, meningocele, meningomylocele, diastematomyelia, sacralization, lumbalization, congenital spondylolisthesis.
These congenital defects of the spine are not traumatic factors for nerve roots and may indicate any congenital defects in the nervous tissue and suggest a general congenital defects of the patient. Variants of the spine are important for reducing its static stability. The lumbar spine carries the weight of the rectified torso. This is the most moving part of the spine, and therefore the waist in humans most often exposed to traumatic factors.
Spine congenital defects found in the cervical and lumbosacral. In the cervical region, along with atlas oxipitalization, and mix a CI vertebra in relation to the vertebra CII can be observed cervical fusion syndrome (Klippel-files). Cervical vertebrae are shapeless bone mass on radiograph. Patients with no neck (head lies directly on the body), limited mobility of the head, the boundary of hair low, there is a scoliosis or kyphoscoliosis.
Anomalies of the dens C2 vertebra in the form of its aplasia (lack of) often meets with the Klippel-File syndrome, Down syndrome, or Mark syndrome.
Anomalies of the dens C2 vertebra in the form of its aplasia (underdevelopment) often meets with the Klippel-File syndrome, Down syndrome, or Mark syndrome.
Cervical fusion (Klippel-Feil syndrome) does not manifest itself like a neurological disease, or is accompanied by a cervical radicular syndrome and pyramidal signs. Often Klippel-Files syndrome combined with the splitting of the lumbar spine (spina bifida) and the presence of cervical ribs, sometimes extended only to cross the appendage, sometimes it comes to the formation of true ribs.
Additional cervical rib syndrome may clinically manifest itself under the influence of unfavorable factors (cooling, trauma, infection). In many cases, additional cervical rib does not make themselves, and have incidental finding on radiograph. Clinical manifestations of extra cervical ribs are characterized by neuralgia pain in the shoulder, which sometimes extend to the entire limb.
Usually there are vasomotor and trophic disorders (pale, cold cyanotic skin, sweating increased pilomotornogo reflex). Sometimes joining muscle weakness and atrophy. Autonomic disorders presence, and in some cases, the sympathetic nature of pain indicates traumatic supplementary ribs cervical sympathetic nerve fibers.
The most common spine congenital defects is the splitting of the vertebrae (spina bifida). Spina bifida malformations fall into four categories: spina bifida occulta, spina bifida cystica (myelomeningocele), meningocele and lipomeningocele. It is rarely possible to observe directly the splitting of the vertebral body. Most cleft arches are either in the LV lumbar, or in the SI sacral vertebrae. In other parts of the spine cleft arches is less common.
There are closed and an open split vertebrae. It is more common closed splitting vertebrae (spina bifida oculta). In spina bifida occulta, the outer part of some of the vertebrae are not completely closed. In most cases, closed splitting vertebrae (spina bifida oculta) is not accompanied by any neurological disorders. An exception may be only bed-wetting.
When closed splitting vertebrae (spina bifida oculta) can also be fuzzy pain in the lumbar-sacral area. Formed cicatricial changes in the roots rise to neurogenic disorders: paresis of legs with the fallout of tendon reflexes, radicular disorders of sensation, trophic and vasomotor symptoms (ulcers, edema, local hypertrichosis, skin changes).
Open split vertebrae are much rarer (one child in 1000-1500 newborns) and are more severe defect of the spine. Usually open combined with the splitting of the vertebral dysplasia of the spinal cord, membranes and roots. After splitting the available vertebrae bulges substance of the spinal cord and membranes.
A cyst protrudes through the defect in the vertebral arch is filled with shells or spinal cord (meningocele), or include as a part and spinal cord (meningomyielocele).
Spina bifida is not linked to any lumbar or sacroiliac injury in adults.
In most serious cases there is a split not only the spine, and spinal cord. Protrude meningeal cyst is not covered with muscle and skin, his wall is the rear surface of the spinal cord (meningomyelocele).
A cyst protrudes through the defect in the vertebral arch is filled with shells and include a part of spinal cord (meningomyielocele).
In more favorable cases of the spina bifida spinal cord is not changed, but in the meningeal cyst contains only the shell (meningocele). Severe forms of meningeal cyst of the spinal cord are accompanied by marked impairments of motor, sensory and pelvic features, trophic disorders.
Diastomatomyelia is a congenital disorder in which a part of the spinal cord is split, usually at the level of the upper lumbar vertebra. Diastomatomyelia is a "dysraphic state" of unknown embryonic origin, but is probably initiated by an accessory neurenteric canal (an additional embryonic spinal canal).
Fixation of the spinal cord and meninges results in low to standing cone and cause Arnold-Chiari syndrome (defect of the brain), the cause of which can be as spina bifida, a congenital low standing of the spinal cord, spinal roots short.
Sacrarization — the first sacral S1 vertebra becomes fused with the fifth lumbar L5 veterbra.
Lyumbarization — nonfusion of the first and second segments of the sacrum S1-S2 so that there is one additional articulated vertebra, the sacrum consisting of one fewer segment.
Clinically sacralization and lumbarization may occur occasionally radicular syndrome in the course of the nerve roots L5 and S1. Causes of congenital disorder of the spinal cord and spinal column are the same as that of congenital disorder of the brain and skull.
Spine congenital disorder with radicular pain may be treated non-surgicaly. Only under persistent syndrome, incapable medication and physical therapy, have resorted to surgical methods — removal of scar changes, adhesions, extra cervical ribs, etc.
Meningeal cyst with or without the spinal cord (meningocele and meningomylocele) treated with a surgical procedure. Good results are observed when the meningeal cyst consists only of shells (meningocele).
Congenital disorders generally carry a good prognosis, except in cases which there is dysplasia of the spinal cord.
Treatment of congenital disorders is divided into:
- drug therapy (NSAIDs, analgesics, hormones)
- therapeutic blockade - the injection of drugs into the cavity of the channel
- manual therapy (muscle, joint and radicular technique)
- physiotherapy (UHF, SMC, etc.)
- spinal traction (contraindicated in the acute stage)
- medical gymnastics and swimming (after primary treatment)
- surgical treatment
In to the intervertebral joints (facet joints) can also be produced by therapeutic blockade, when conventional treatment does not give positive effect. Usually this is just low doses of anesthetic (Novocaine, Lidocaine) and cortisone, injected into the lumen of the affected joint.
In the treatment of pain in the leg eliminating pain, tingling and restoration of sensitivity in the leg with neuritis of the sciatic nerve compression in the event of a hernia or a disc protrusion is accelerating the use of physiotherapy.
Wearing a rigid or soft lumbar corset (brace) helps to limit the range of motion in the lumbar spine. This lumbosacral corset (brace) helps reduce pain, inflammation in the area of intervertebral joints and removal of excess voltage protection and spasm of back muscles.
In such rigid or soft lumbar corset (brace) patient can walk independently at home and on the street, sit in the car and at the workplace. The necessity of wearing a rigid or soft lumbar corset (brace) is to be discontinued as soon as is back pain.
There are several types of rigid or soft lumbar corset (brace). A rigid brace is used when despite surgical correction (or in place of surgical correction) spinal stability has not been fully achieved. The soft lumbar corset is used primarily for muscular support in the treatment of back pain.
All of them are selected by size and can be repeatedly used in case of recurrence of back pain.
If you have any questions about the diagnosis or treatment of the Klippel–Feil syndrome, cervical rib, spina bifida, meningocele, meningomylocele, diastematomyelia, sacralization, lumbalization, congenital spondylolisthesis, you can specify them with our neurosurgeon or neurologist by calling: (499) 130–08–09
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- Spinal cord and spine congenital defects (Klippel–Feil syndrome, cervical rib, spina bifida, meningocele, meningomylocele, diastematomyelia, sacralization, lumbarization, spondylolisthesis)
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