Spinal Cord is a structure belonging to the central nervous system and connects the brain with the rest of the organism. Through the spinal nerves, it carries information to the other organs and the other parts of the body and sends signals from the rest of the organism to the brain.
The spinal cord can be seen as a column of nerve fibers which, flowing inside the vertebral column, connects the brain with the rest of the organism. About 1-1.5 cm wide and 40 to 50 cm long, it begins at the level of the so-called foramen magnum (or occipital hole, an opening located at the base of the cranial box) and ends at the level of the first or second lumbar vertebra.
It consists of an external white substance (composed of neuronal extensions) and an internal gray element (formed by the bodies of neurons) and is divided into four regions (cervical, thoracic, lumbar and sacral) each of which is formed by several segments , from which there are a total of 31 pairs of spinal nerves containing each motor nerve fibers and sensory nerve fibers.
Are You In Constant Pain? Here Is What Could Be Wrong With Your Back
People tend to take the pain in the back lightly, they blame a bad move or even the mattress were they have been sleeping for years without any problem. Stress goes directly to the muscles in our back making our existence a very painful experience. The way we sit and stand can also affect the levels of pain we have on a regular basis and the normal thing is to ignore it.
In most cases, people take a painkiller and call it a day, before they know they must take the pills to go through their routine. Then the pain becomes a problem but only when it is unavoidable people decide to get help. This is an unhealthy behavior to say the least but what most people do not know is that back pain could be caused by an undetectable injury but also by a number of diseases.
We must not take our spinal cord for granted, with our brain they make the central nervous system. The spinal cord is the highway in our body that all of the information about our nerves travel. It takes information from the motor cortex to the body and it is in charge of our reflexes. Our spinal cord is a delicate part of our body and even the smallest of the accidents could harm it.
- Spinal Stenosis
- Spinal Cord
- Spinal Cord Injury
- Incomplete Spinal Cord Injury
- What protects the Spinal Cord?
- Spinal Cord Tumor
- Spinal Meningitis
- Lumbar Spinal Stenosis
- Spinal Cord Stimulator
- Spinal Cord Function
- What is Spinal Stenosis
- Spinal Cord Cross Section
- Spinal Cord Diseases
- Lower Back Pain
- Tethered Spinal Cord
- Spinal Cord Anatomy
- Spinal Cord Compression
- Spinal Cord Diagram
The term sciatica describes the symptom or pain along the sciatic nerve pathway, rather than a specific illness, disease or medical condition. It could mean any leg pain, accompanied with such effects as tingling, numbness, or weakness, which originates from the lower back, going through the buttock and down the large sciatic nerve located in the back of each leg. In diagnosis, it could accurately mean a nerve dysfunction caused by compression of one or more lumbar or sacral nerve roots from a spinal disc herniation.
The most common cause of Sciatica is the spinal disc herniation pressing on one of the lumbar or sacral nerve roots. Another compressive cause is lumbar spinal stenosis a condition in which the spaces through which the spinal cord runs through (spinal canal) narrows, hence compressing the spinal cord. Pregnancy may also cause Sciatica due to the weight of the fetus pressing on the sciatic nerve while sitting or when the leg spasms, likewise tumors impinging on the spinal cord or the nerve roots.
Spinal stenosis is the condition in which the spinal canal or neural foramen starts narrowing abnormally, resulting in pressure on the spinal cord or nerve roots, and causing great pain and other problems. It is best diagnosed by a complete evaluation of the spine through physical examination and medical history.
There are two most common forms of spinal stenosis, the cervical spinal stenosis which are at the level of the neck, and the lumbar spinal stenosis, found at the level of the mid-back.
The leading cause of spinal stenosis is osteoarthritis, a condition developed as a result of the breakdown of cartilage and the growth of bone tissue. Other causes may include spinal tumors, trauma, and rheumatoid arthritis, Paget’s disease of the bone, scoliosis, and achondroplasia (a genetic condition).
The spinal cord is a long, tube-like, fragile structure that starts from the end of the brain stem and continues downward almost to the end of the spinal column or spine. Also the center for reflexes, it consists of nerves carrying incoming and outgoing messages between the brain and other parts of the body. It is similar to the brain in that it is covered by a three-layered tissue, called meninges. The meninges, alongside the spinal cord, are contained in the spinal canal, which runs through the spine.
The human spinal cord is segmented, there is a form of spinal nerves (mixed, sensory and motor) in pairs, in each of the segments. Just like the brain, there is gray and white matter in the spinal cord as well. The center of the cord, which is butterfly shaped, consists of the gray matter. The front and back horns contain motor nerve cells and sensory nerve cells respectively. These are surrounded by white matter, which contains nerve fiber columns responsible for the transportation of information to the brain from the other parts of the body.
Spinal Cord Injury
Spinal Cord Injury (SCI) refers to damage to the spinal cord that leads to a temporary or permanent modification to its mode of function. Such changes may lead to loss of muscle sensation, function or automatic functioning of parts of the body that are linked to and served by the spinal cord. These body parts are usually below the level of the lesion. Spinal cord injuries can be classified as a complete or an incomplete SCI. A complete spinal cord injury means a total loss of muscle function and sensation, while an incomplete SCI means some nervous signals are still able to travel through the injured area of the cord.
SCI is mainly as a result of physical trauma like gunshots, falls, car accidents or sports injuries, though its causes can also be non-traumatic as in tumors, insufficient blood flow and infection. Symptoms of spinal cord injury depend extensively on the location and severity of the damage along the spinal cord. These symptoms range from pain or numbness to paralysis and incontinence.
Incomplete Spinal Cord Injury
This refers to damage to the spinal cord that is not total or absolute. The level of an incomplete spinal cord injury varies largely from an individual to another, and it entirely depends on the way the spinal cord has been compromised. The exact extent of most incomplete injuries is only ascertained after 6 to 8 weeks of the injury. Incomplete injuries manifest in a lot of ways, some of the known ways include:
CaudaEquina Lesion: This causes damage to the nerves situated between the first and second lumbar regions of the spine. Repair or regeneration of some nerves is possible to improve function
Anterior cord syndrome: This occurs as a result of an injury to the front of the spinal cord, thus interfering with such sensations as pain, touch, and temperature. Most survivors of this injury can recover some movement.
Posterior cord syndrome: This is as a result of damage to the back of the spinal cord. Though they struggle with poor coordination, most survivors maintain good posture, muscle tone, and some movement.
Central cord syndrome: This happens when the center of the cord is damaged or affected. Usually, there is the loss of sensation and survivors may be able to move their legs, but they rarely recover movement in their arms.
What protects the Spinal Cord?
The spinal cord is protected by discs, ligaments, muscles and more importantly bones. There are 33 bones in the spine, called vertebrae. There is a hole in the center of each vertebra, called the spinal canal, through which the spinal cord passes. Some discs act as shock absorbers for the spine between the vertebrae. The ligaments and muscles ensure the vertebrae are correctly positioned.
Spinal Cord Tumor
This refers to a benign (noncancerous) or malignant (cancerous) growth around or in the spinal cord. Such growth leads to weak muscles, loss of sensation in some parts of the body, inability to control the bladder and bowel. Spinal Cord tumor can be detected using magnetic resonance imaging. Best treatment methods include surgical removal, radiation therapy or both.
The spinal cord may be primary or secondary. Primary spinal cord tumors can be cancerous or noncancerous, and they mostly originate in the cells within or next to the spinal cord. Secondary spinal cord tumors are more common and are always cancerous. They compress the spinal cord or nerve roots from the outside, and they spread to the vertebrae from cancers originating in the lungs, kidneys or prostate gland.
Meningitis, often referred to as spinal meningitis, is an inflammation of the membranes surrounding the brain and spinal cord. It is usually caused by a viral infection, but can sometimes be bacterial or fungal. Depending on the type of infection, this disease can be treatable or potentially fatal.
Viral etiology is less severe and self-limited, without specific treatments, while bacterial meningitis can manifest itself severely and can result in brain damage, hearing loss or learning problems. In the case of bacterial meningitis, it is imperative to identify the pathogen to use the appropriate, active drug, and thus avoid the spread of infection.
Lumbar Spinal Stenosis
Lumbar spinal stenosis is a condition caused by narrowing of the vertebral canal. In medical terms, stenosis refers to the reduction of a duct or passage.
Over the years, variations in the size and shape of the vertebral canal are part of the natural aging process. However, some changes, such as narrowing the canal, can cause pain.
The size and shape of the vertebral canal change with aging. Under normal conditions, the vertebral foramen is large enough to accommodate the nerve fibers that branch off from the spinal cord. However, if these foramen shrinks (due to excessive growth of the bone or adjacent tissue), nerve compression and therefore pain may occur.
The narrowing associated with lumbar spinal stenosis may also involve the spinal cord, which is forced to “invade” the free space in the vertebral canal.
This problem forced the withdrawal from the competitive activity of many athletes, especially wrestlers, such as Edge, Paige, and Sheamus who fought in the WWE.
Spinal Cord Stimulator
Stimulation of the spinal cord is a non-pharmacological analgesic treatment that consists in conveying electric current on some nerve fibers of the spinal cord to interrupt the conduction of the stimuli responsible for the pain.
When is Spinal Stimulation indicated?
The spinal cord stimulator is indicated when the examination showed that the patient is suffering from one of the following pain syndromes:
- Cervicobrachial or chronic lumbosacral radiculopathy
- peripheral neuropathy
- complex regional pain syndrome
- angina pectoris
- arteriopathies of the lower limbs
There is no pain because the procedure is performed under local anesthesia.
Recently the wrestler Hulk Hogan decided to use a spinal cord stimulator to relieve the constant back pain due to 30 years of competitive activity as a wrestler, problems that prevented him from walking properly.
Spinal Cord Function
The spinal cord belongs to the central nervous system and is the structure that connects the brain with the rest of the body: the nerves that arise from the spinal cord, coming out of small openings located between the vertebrae (the format), connect with specific parts of the ‘body. Severe damage to the spinal cord can cause paralysis of some areas of the body and not in others.
The nerves of the cervical area are directed towards the upper part of the chest and the arms. Those in the thoracic region innervate the chest and abdomen. Those in the lumbar area instead head towards the intestine, the bladder, and the legs. Taken together, all these nerve fibers coordinate and control the different parts of the body, organs, and muscles.
Also, the nerves also carry electrical signals from the periphery of the body into the brain. This allows us to perceive the most different sensations, from heat to pain. Damage to the nerves can also trigger feelings (such as pain, tingling or numbness) in areas where they flow.
The spinal cord function is to connect all the nerves to the brain, without this activity it would not be possible to move and have sensations.
What is Spinal Stenosis
What is spinal stenosis? The spinal stenosis is a narrowing of the canal through which the spinal cord passes that can occur in one of the regions of the spinal column. When shrinkage happens, the roots of the nerves and the marrow are crushed with severe consequences.
Spinal stenosis can occur at any level of the spine, even if it tends to happen in the lower back (lumbar spine) or the neck (cervical spine). If it occurs in the lower back, it is called “lumbar spinal stenosis,” while if it occurs in the neck, “Cervical Spinal Stenosis.”
The pathology in congenital form is very rare, but it is prevalent especially among seniors because the narrowing of the spinal canal can occur due to changes in the spine due to the aging process.
The most common symptoms are:
- low back pain;
- loss of motor control;
- muscle weakness;
- a headache.
Spinal stenosis does not cause pain in all the patients because often the canal shrinks but does not press on the bone marrow and nerve roots.
The pathology of spinal stenosis should be taken care of when the first symptoms are started, and it is essential to consult a specialized doctor who can indicate the right therapy to follow.
In the initial stages, the therapy is conservative through the use of anti-inflammatory drugs. In a second moment, it may be necessary to intervene with minimally invasive procedures or with pulsed radiofrequency sessions.
Spinal Cord Cross Section
The spinal cord is a cylindrical nerve structure, housed inside a vertebral column and ideally subdivided into four regions: the cervical region, the thoracic region, the lumbar region and the sacral region.
On average 45 cm in men and 43 cm in women, it has a variable diameter, ranging from 13 mm in the cervical region and the lumbosacral region (the so-called “bulges”) to 6.4 mm in the thoracic region.
On the web, it is possible to find photographs and diagrams of a Spinal cord cross-section.
Spinal Cord Diseases
Spinal cord diseases can cause severe permanent neurological deficits or permanently compress mobility and quality of life. For some patients, such damage can be avoided or reduced if diagnosis and treatment are early.
Spinal cord diseases are generally due to extrinsic diseases of the marrow itself, such as the following:
- Compression due to spinal stenosis
- Slipped disc
These disorders must be treated immediately to try to limit the damage and to get back in the shortest possible time to move in the best way.
Lower Back Pain
It is common after certain activities to have a little of pain of the lower back but sometimes the reasons are not that obvious. Back pain is a tricky situation, it could be absolutely nothing or the first symptom of a serious disease. It is hard to reach a diagnose since the x-ray or the MRI do not help on this particular area.
The pain can start due to stress but also it could be caused by an injury in the spinal cord. Whatever the reason may be, it is better to make an appointment with a professional as soon as possible. If the cause is any kind of autoimmune disease, being aware of it soon could make a big difference.
A chiropractor is a health professional that treats neuromuscular disorders. The treatments they apply will depend on the patient but one of the most common is the manual adjustment of the spine.As an alternative to traditional medicine, a chiropractor gives their patients the tools to correct the issues without any kind of surgery or chemicals.
The no-invasive treatments are highly beneficial for patients with small injuries, they will not end up with a scar and will not require time off to recover.
Tethered Spinal Cord
Is it a syndrome that affects up to 50% of the children with diagnosed spina bifida. This neurological disorder is known for the attachment of tissue that as a consequence limits the movement of the spinal cord. Another effect is the atypical expanding of the spinal cord.
There are several possible origins for the tethered spinal cord syndrome, the most common is the spina bifida but it could also be caused by congenital deformities, a split spinal cord, traumas in the spine and tumors. Patients with this syndrome are in constant pain and tend to show symptoms like skin discoloration and a drastic decrease in their strength.
It is possible to detect this syndrome through a MRI. Patients with this syndrome require a surgery to correct it, they will be able to return to their normal lives after a couple of weeks of recovery.
Spinal Cord Anatomy
The spinal cord is divided in 31 segments, each one of them has a function and spinal nerves coming off.
- Lumbar: Made of 5 pairs of nerves, this section takes most of the weight so it is a tough structure and the segment with the highest mobility.
- Thoracic: It has 12 pair of nerves, this segment is particularly rigid because with the rib cage, they protect the heart and the lungs.
- Cervical:8 pairs of cervical nerves make up the most fragil section of the spinal cord.
- Coccygeal:It is one segment without intervertebral discs.
- Sacral: Originally it has 5 pairs of nerves but once the individual reaches adulthood all of the discs are merged together.
It is a curvature in the spine shaped like a letter S or a letter C. Scoliosis starts at the end of the childhood and beginning of the adolescence. Females are most likely to develop scoliosis than their male counterparts.
The patient with scoliosis often have uneven shoulders and hips or they are constantly inclined to a side when they are standing. It is not hard to detect it and the treatment will depend on how bad the curvature is.
The mild cases will need regular checkups to keep track of the curvature, severe cases will require surgery. If it is detected at a young age, the patient will need a brace that will not limit their movements but will prevent a worse outcome.
Spinal Cord Compression
The first symptom is back pain and the compression occurs at any level of the spinal cord, the responsible could be a fragment of bone after a fracture, an intervertebral disc or a tumor. No matter what is causing the compression, it is considered a medical emergency and it should be treated immediately.
Some of the symptoms include urinary incontinence and insensitivity in the areas below the compression, some cases could also include paralysis. It is easy to spot the compression in an x-ray and the level will determine how much the patient will recover.
There are two possible treatment, one includes oral medicine and it helps protect the spinal cord from further injuries. The second treatment consist in a surgery but this option is considered only if there is hope of partial recovery.
Spinal Cord Diagram
A detailed representation of the spinal cord that includes each segment and explains exactly what part of the body is controlled by which segment. The diagrams are used to determine the level of the injuries and from there it is possible to make decisions about the treatment.
Understanding how the spinal cord works is the first step to develop treatments. The spinal cord is the second most important part of our body surpassed only by the brain. The nervous system is vulnerable because it does not takes much to damage it permanently.
People should be cautious of any incident that results on trauma, do not wait for the symptoms to show, if you suspect you could have any kind of damage on your spinal cord, make an appointment with a professional.