Tổng quan: lịch sử điển hình của bệnh của tủy sống bao gồm suy giảm tiến triển từ từ dáng đi, thường có tính chất không rõ nét bàng quang rối loạn chức năng, cảm giác bất thường ảnh hưởng đến chi dưới, hoặc một nửa dưới của cơ thể dưới một mức độ cụ thể trên thân cây | 3 Diseases Mainly Affecting the Spinal Cord rCharacteristics of Diseases of the Spinal Cord Overview The typical history of diseases of the spinal cord consists of slowly progressive impairment of gait often of a poorly defined nature bladder dysfunction sensory abnormalities affecting the lower limbs only or the lower half of the body below a particular level on the trunk band-like pain or a feeling of constriction on the trunk and back pain at the level of the lesion. Patients frequently complain of an electric shock-like sensation traveling from the neck or back downward possibly into the extremities on flexion of the neck or certain other movements of the trunk Lhermitte sign p. 470 and rarely of restless legs. Physical examination typically reveals spastic para- or quadriparesis with hypertonia hyperreflexia and pyramidal tract signs though any of these findings may be absent in individual cases a sensory deficit below a particular level on the trunk in some cases spinal muscular atrophy perhaps with fasciculations normal function of the cranial nerves and normal function of the upper limbs as well for lesions at thoracic or lower levels. Ancillary tests particularly neuroimaging studies are essential aids to the diagnosis of spinal cord diseases. Ancillary Tests in Diseases of the Spinal Cord Neuroimaging of the Spine and Spinal Cord Plain films provide a projectional view of the bony structures of the spine. Tomographic studies CT MRI enable cross-sectional and threedimensional views of both the musculoskeletal and the neural structures. Dynamic studies such as plain films in flexion and extension can provide evidence of spinal instability 254 . MRI and CT MRI and CT are the most useful imaging studies of the spinal cord itself. MRI is generally more informative than CT for study of the cervical or thoracic region though CT with fine cuts can be as good as MRI or better in the lumbar region particularly when clinical evidence points to a monoradicular lesion
