Welcome to the second episode of TNA Brain Waves. In this episode Jen and Meshia will cover the questions we received regarding spinal diseases.
Meshia explain the difference between myopathy, myelopathy, and radiculopathy. Myopathy is a muscle cell disease. Radiculopathy is a nerve root disease which is the most common in the cervical and lumbar regions.
Jen cover neuropathy which is a nerve disease, specifically used to describe peripheral nerves. Neuropathy affects more than 3 million people in the US. Diabetes is the most common cause of neuropathy and the symptoms range from pain and paresthesia to numbness.
Jen and Meshia explained that herniated nucleus pulpous is when the disk ruptures through the annulus fibrosis and it can pinch or irritate the nerve. 90% of of the herniated nucleus pulpous occur at L4-L5 or L5-S1. Degenerative disc disease is when the annulus fibrous actually breaks down and it is associated with chronic stress, age, and possibly some genetic factors. Degenerative disc disease is very common with approximately 30% of people between the ages of 30 – 50 suffering from some form of degenerative disc disease.
They also cover spondylolithesis, which is a spinal condition in which the superior vertebra slips forward anteriorly over the inferior vertebra. Adolescence who play sport are most at risk, especially those that are involved in gymnastics, football, or weight lifting.
Spondylosis is a blanket term for any spine degeneration. Chronic stressors, age, and genetics contribute to spondylosis.
Jen and Meshia continue with the different curvatures of the spine. Scoliosis is when the spine has a rotation curvature. It is very common with more than 3 million people diagnosed with it each year in the US. Idiopathic scoliosis affects about 2% of the population and there is no known cure. It affects adolescences and is usually identified during a school screening or a normal doctors appointment. Curvatures with less than 20% don’t normally need treatment. Curvatures over 50% are likely to progress into adulthood and can cause cardiopulmonary compromise if left untreated.
Jen explained kyphosis and lordosis. Kyphosis is excessive rounding of the back or excessive convex curvature that is found in the thoracic area. Older woman usually have kyphosis when they suffer from osteoporosis, which causes the bones to weaken and compress. It is also seen in infants and teens with spine malformations. Lordosis is predominately found in the lumbar region, and is also called swayback. It is excessive concave curvature.
Meshia explained the difference between a burst fracture and a compression fracture. A burst fracture is when the vertebra is crushed in all directions. A compression fraction is when the vertebra is crushed in the front. Both cases are severe.
Finally, they discuss Central Cord Syndrome, Anterior Cord Syndrome, and Brown Sequard Syndrome, Central Cord Syndrome affects the central gray matter and the spinothalamic tracts that cross over. It is caused by lesions in the gray matter, or more commonly from a hyperextension injury in patients long suffering from spondylosis. It is characterized by disproportionate greater motor impairment in the upper extremities than in the lower extremities, bladder dysfunction, and variable degrees of sensory loss below the level of injury.
Anterior cord syndrome is also known as anterior spinal artery syndrome and it occurs when the anterior spinal artery is occluded. Patients will have a loss of motor function bilaterally and a loss of temperature and pain sensations below the level of injury because of the involvement of the corticospinal and spinothalamic tracts. Causes of anterior cord syndrome range from a herniated disc, to an infection, and even to cocaine abuse, but the most common is an automobile accident or a fall.
Brown Sequard Syndrome is unique because it affects the spinal cord unilaterally. It is caused because of a lesion or an infection. The patients will have an ipsilateral loss of motor function and a contralateral loss of temperature and pain sensitivity. The ipsilateral loss of motor function is because of the involvement of the corticospinal tracts and the contralateral loss of pain and temperature sensitivity is due to the involvement of the spinothalamic and sponiocerebellar tracts.
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