neurologic disorders
Spinal Tumors
Symptoms and Signs of Spinal Tumors
Spine tumors manifest with three defined pain syndromes: Biologic (so-called) Mechanical Radiculopathy (radicular) Biologic painis typically the earliest symptom of all spinal tumors. The pain usually occurs at night or early in the morning and resolves with activity. It is thought to be caused by inflammatory mediators secreted by the tumor, which are influenced by the diurnal variation in endogenous corticosteroids secreted by the adrenal glands or by administration of exogenous corticosteroids. Mechanical painis caused by a spinal fracture and is worsened by movement or activity. Radiculopathy(radicular pain) results from nerve root compression and follows the distribution of a nerve root. Intradural extramedullary tumors may be painful when the nerve roots are compressed but can develop painlessly if the spinal cord is directly compressed without involving the root. Neurologic deficits referable to the affected level of the spinal cord may develop. Common examples are spastic weakness, incontinence, and dysfunction of some or all of the sensory tracts at a particular level of the spinal cord and below. Deficits are usually bilateral. Some patients with intradural tumors—most often meningiomas and schwannomas—present with sensory deficits of the distal lower extremities, segmental neurologic deficits, symptoms of spinal cord compression, or some combination. Symptoms of Spinal Cord Compression can worsen rapidly and result in paraplegia and loss of bowel and bladder control. Symptoms of nerve root compression are also common; they include pain and paresthesias followed by sensory loss, muscular weakness, and, if compression is chronic, muscle wasting, which occurs along the distribution of the affected roots. 