Lub kwj dej ntawm tus txha caj qaum yog cov kab noj hniav uas kaw cov qaum qaum ntawm lub plawv ntawm tus txha nraub qaum. Nws tuaj yeem yog qhov chaw ntawm qhov txhab ntawm ntau yam, ua rau txha caj qaum compression ua rau mob, lub cev muaj zog thiab kev puas siab puas ntsws.

Lub medullary kwj dej, tseem hu ua medullary kab noj hniav, yog kab noj hniav nyob rau hauv tus txha nqaj qaum uas muaj tus txha caj qaum.

Raws li kev ceeb toom, tus txha caj qaum, lossis txha caj qaum, yog ib feem ntawm lub hauv nruab nrab lub paj hlwb. Ib qho txuas ntxiv ntawm lub hlwb, qhov qaum ntawm txog plaub caug centimeters tso cai rau kev sib kis ntawm cov ntaub ntawv ntawm lub hlwb thiab lub cev, los ntawm cov leeg txha caj qaum uas tawm ntawm nws los ntawm qhov sib txuas.

Cov kwj dej medullary kaw thiab tiv thaiv tus txha caj qaum.

Kev ua haujlwm ntawm pob txha nraub qaum

Peb tham txog tus txha caj qaum compression thaum tus txha caj qaum thiab cov hlab ntsha uas sib cais los ntawm nws raug mob los ntawm kev raug mob. Qhov no compression ces ua rau mob nyob rau hauv lub nraub qaum, irradiation thiab nyob rau hauv feem ntau mob ntawm lub cev muaj zog, sensory thiab sphincter teeb meem.

Cov kab mob ua rau lub compression tuaj yeem nyob sab nraum qaum qaum (extramedullary lesion) los yog sab hauv (intramedullary lesion) thiab yuav, nyob ntawm seb nws qhov xwm txheej, mob lossis mob ntev. Nws tuaj yeem yog:

• ib tug herniated disc 
• subdural los yog epidural hematoma tom qab ib tug raug mob ua rau ib tug ligament los yog pob txha raug mob, lumbar puncture, noj tshuaj anticoagulant.
• pob txha tawg, vertebral compression nrog cov pob txha tawg, vertebral dislocation lossis subluxation
• qog nqaij hlav (tshwj xeeb tshaj yog metastatic extramedullary qog)
• mob meningioma, neuroma
• ib ntus
• pob txha compression vim osteoarthritis
• arteriovenous malformation
• cervicarthrosis myelopathy

Cauda Equina Syndrome

Qhov chaw ntawm tus txha caj qaum nyob rau ntawm theem kawg ntawm lub lumbar vertebrae thiab lub sacrum, thiab los ntawm qhov uas tshwm sim ntau cov paj hlwb txuas nrog rau cov ceg qis thiab cov sphincters, hu ua ponytail.

Thaum tus txha caj qaum compression zaum ntawm theem ntawm tus ponytail, feem ntau vim yog herniated disc, nws tuaj yeem ua rau cauda equina syndrome. Qhov no yog tshwm sim los ntawm qhov mob qis dua, mob hauv thaj tsam perineum thiab hauv cov ceg qis, tsis hnov ​​​​tsw, ib nrab tuag tes tuag taw thiab sphincter mob. Qhov no yog kev kho mob xwm txheej ceev. 

Lub medullary infarction

Tsis tshua muaj, qhov mob ntawm lub hauv paus chiv keeb ntawm tus txha caj qaum compression slows lub arterial vascularization, ces ua rau medullary infarction.

phais

Kev phais yog tus qauv kho rau tus txha caj qaum compression. Cov kev cuam tshuam, hu ua laminectomy, muaj kev tshem tawm ntawm qhov posterior ntawm lub vertebra (los yog hniav) nyob ib sab ntawm qhov txhab, ces tshem nws thiaj li decompress cov pob txha thiab nws cov hauv paus hniav. Qhov kev cuam tshuam no kuj ua rau nws tuaj yeem txheeb xyuas qhov mob.

Nyob rau hauv cov ntaub ntawv ntawm cauda equina syndrome, qhov kev phais decompression yuav tsum tau ua sai sai kom tsis txhob muaj lub cev muaj zog, hnov, sphincter thiab kev sib deev sequelae.

Yog tias qhov mob ua rau tus txha caj qaum compression yog hematoma lossis abscess, cov no yuav raug phais.

Radiotherapy

Nyob rau hauv cov ntaub ntawv ntawm qog nqaij hlav cancer, radiotherapy qee zaum ua ke nrog kev phais.

Kev soj ntsuam kuaj mob

Tau ntsib nrog lub cev muaj zog, kev hnov ​​​​lus, sphincter lossis qhov mob tshwm sim tam sim ntawd, nws yog ib qho tseem ceeb rau kev sab laj yam tsis muaj kev ncua. Tus kws kho mob yuav xub ua ib qho kev kuaj mob los qhia kev kuaj mob raws li cov tsos mob thiab palpation ntawm tus txha nraub qaum.

MRI

MRI yog tus qauv kub rau tus txha caj qaum. Nws ua rau nws muaj peev xwm nrhiav tau qhov chaw ntawm tus txha caj qaum compression thiab coj mus rau kev kuaj thawj zaug raws li qhov xwm txheej ntawm qhov txhab. Nyob ntawm qhov kev qhia rau kev kuaj mob, kev txhaj tshuaj ntawm Gadolinium tuaj yeem ua.

CT myelography

Thaum MRI ua tsis tau, CT lossis CT myelography tuaj yeem ua tiav. Qhov kev ntsuam xyuas no muaj xws li txhaj tshuaj opacifying rau hauv tus txha caj qaum kom pom cov contours ntawm tus txha caj qaum ntawm x-rays.

X-ray txha caj qaum

Yog tias xav tias muaj pob txha pob txha, X-rays ntawm tus txha caj qaum tuaj yeem muab ntxiv rau MRI.

Medullary arteriography

Qee qhov xwm txheej, ib qho arteriography tuaj yeem ua tau los saib seb puas muaj vascular lesion. Nws muaj kev txhaj tshuaj, nyob rau hauv cov tshuaj loog hauv zos, cov khoom sib txawv tom qab ntawd noj cov duab hauv cov hlab ntsha thiab cov hlab ntsha ntawm cov hlab ntsha ntawm cov khoom no.