Neoplastic spinal cord compression

Neoplastic spinal cord compression

    * Introduction
    * Clinical
    * Diagnostic Laboratory
    * Treatment
Spinal compressions cause a syndrome in which the bone marrow and the roots are compressed by a process of replacement space. Spinal tumors are more rare than the skull, the ratio being 1 / 5. The most frequently in adults between 20 and 40 years. Tumors of the spinal canal may be extramedullary or intramedullary. The extramedullary turn can be epidural or intradurale.
In terms of pathology, neoplasms may develop from nerve tissue or bone marrow or tissue found in the meninges or outside the dura, or even spinal roots. Most tumors are extramedullary and epidural. Histologically, neoplasms that develop directly from bone marrow are called glioma tissue, those that grow from the spinal roots are called neuromas, and tumors that develop in the shell are called spinal meningioma. As indicated above, most neoplasms are epidural metastases and sarcomas and are the result. Very rarely can develop tuberculoame at this level to determine a compression syndrome.
Metastatic epidural neoplasms that cause the development is at the vertebral body or the spinous or transverse. Retroperitoneal neoplasms may enter the spinal canal at the intervertebral holes. Is particularly lymphomas and sarcomas. Before determining spinal cord compression, retroperitoneal neoplasms causing radicular pain. Among the malignant tumors that can metastasize to the bone marrow, most frequently metastasized breast tumors, lung tumors, prostate, kidney, lymphoma and plasma cells dyscrasia. Topographically speaking, the vast majority of spinal canal tumor occurs in the thoracic level. Metastatic prostate and ovarian tumors affects mainly lumbar and sacral vertebrae, these tumors metastasize via Batson plexus, represented by a network of veins located in front of the spinal, epidural space.
Extramedullary tumors are the most common. In their majority they are meningiomas and neuromas.
- Meningiomas grow mainly in arachnoid, to the lower insertion of the ligament toothed. Represents about one third of all extramedullary tumors. Meningiomas that develop outside the dura, a surround it like a sleeve. They are usually benign tumors that usually occur after age 30 years. They meet more often in women. From Histologically, meningiomas is an epithelial tumor type. It adheres firmly to last, gray and hard consistency. Most meningiomas grow in the thoracic region.
- Neurinomul cells develop from Schwan. Its location is usually subdural, growing out of the posterior root. Over time, the tumor grows in size and can exceed the spinal canal, exiting through the hole conjugation. Topographically, the tumor develops especially in the area of horse tail, but may meet on all floors of the column. Histologically, neurinomul is a benign, encapsulated, semi-hard or soft consistency, sometimes cystic. Cells, elongated form, is available in the vortices. Do not join the last. In evolution, the tumor can erode the vertebral pedicle and blades. Very rarely degenerate into sarcoma. Intramedullary tumors are mostly glioma. In general, these tumors evolve slowly over 10-20 years. The most common are ependimoamele but meet and spongioblastoame, astrocytomas and meduloblastoame.
- Ependymoma is a benign tumor and may reach large dimensions. Usually invade the tail region of horses, being able to extend through holes conjugation. It can stretch the length of 6-8 vertebrae. It forms the ependymal spinal cord or filum terminal. Histologically, the tumor is infiltrative, but compressed spinal cords in evolution. The tumor is developing about 5-10 years. Not recur after surgery.
- Glioblastoma and medulloblastoma are infiltrating tumors that infiltrate the spinal cords. Besides the tumors described above can meet vascular tumors (angioma), colesteatoame, lipomas or tumor origin in the spinal plate.