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Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 34

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Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 34. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | 312 Section Patient Assessment der is the spinal decompression syndrome which can be seen in scuba divers. When the time requirement for decompression after deep diving is not adequately followed decompression sickness microembolisms of non-resolved nitrogen gas emboli can obstruct small branches of the anterior spinal artery and cause a spinal ischemia. This can induce an anterior central cord syndrome or even complete SCI and represents one of the most serious complications in diving 2 19 57 59 87 . In contrast hemorrhagic disorders are mostly based on arteriovenous malformation or spontaneous spinal bleeding in patients with anticoagulation treatment and often result in complete paraplegia. Neurodegenerative disorders can be easily confused with spinal disorders particularly in the early stages Neurodegenerative Disorders Based on its frequency multiple sclerosis is the most important differential diagnosis in suspected disorder of the spinal cord. Increased reflexes ataxia numbness and paresis of limbs and bladder dysfunction can occur in both multiple sclerosis and myelopathy. However the presence of MRI signal changes white spots in T2 weighted images in the brain and of the spinal cord without or with only minor spinal cord compression indicating neurodegenerative-immunologic disorders should be taken into the differential diagnosis. The definitive differential diagnosis demands further diagnostics particularly the examination of evoked potentials and the CSF 14 50 52 63 94 . Also very rare neurodegenerative disorders e.g. amyotrophic lateral sclerosis ALS in combination with minor degenerative spinal disorders can potentially mimic a spinal disorder. Inflammatory Disorders A number of infectious diseases can be associated with myelitis. Various viruses i.e. herpes virus human immune deficiency virus or poliomyelitis may affect the spinal cord roots or peripheral nerves. With regard to the opportunities for therapy the diagnosis of a bacterial or viral .