Spinal cord Health Dictionary

Spinal Cord: From 3 Different Sources


A cylinder of nerve tissue that runs from the brain, down the central canal in the spine to the 1st lumbar vertebra. Below that, the nerve roots continue within the canal as cauda equina.

Grey matter, the spinal cord’s core, contains the cell bodies of nerve cells. Areas of white matter (tracts of nerve fibres running lengthwise) surround the grey matter. Sprouting from the cord on each side at regular intervals are the sensory and motor spinal nerve roots. The small nodule (ganglion) in each sensory root comprises nerve cell bodies. Nerve roots combine to form the spinal nerves that link the spinal cord to all regions of the trunk and limbs. The entire spinal cord is bathed in cerebrospinal fluid and surrounded by the meninges.

The nerve tracts in the white matter act mainly as highways for sensory information passing up to the brain or motor signals passing down. However, the cord processes some sensory information itself and provides motor responses without involving the brain. Many reflex actions are controlled in this way.

The spinal cord may be injured by trauma (see spinal injury); spinal-cord infections such as poliomyelitis are rare but can cause serious damage.spinal fusion Major surgery to join 2 or more adjacent vertebrae. It is performed if abnormal movement between adjacent vertebrae causes severe back pain or may damage the spinal cord. spinal injury Damage to the spine and sometimes to the spinal cord. Spinal injury is most often the result of falling from a height or of a road traffic accident. Damage to the vertebrae and their ligaments usually causes severe pain and swelling of the affected area. Damage to the spinal cord results in paralysis and/or loss of sensation below the site of injury.

X-rays of the spine are carried out to determine the extent of damage. If the bones are dislocated, surgery is needed to manipulate them back into position. Treatment with the drug methylprednisolone within a few hours of an injury aids recovery from spinal-cord damage. Surgery may be needed to remove any pressure on the cord, but damaged nerve tracts cannot be repaired. Physiotherapy may stop joints locking and muscles contracting as the result of paralysis.

If there is no spinal-cord damage, recovery is usually complete.

In cases of spinal-cord damage, some improvement may occur for up to 12 months.

Health Source: BMA Medical Dictionary
Author: The British Medical Association
This is the lower portion of the CENTRAL NERVOUS SYSTEM which is situated within the SPINAL COLUMN. Above, it forms the direct continuation of the medulla oblongata, this part of the BRAIN changing its name to spinal cord at the foramen magnum, the large opening in the base of the skull through which it passes into the spinal canal. Below, the spinal cord extends to about the upper border of the second lumbar vertebra, where it tapers o? into a ?ne thread, known as the ?lum terminale, that is attached to the coccyx at the lower end of the spine. The spinal cord is thus considerably shorter than the spinal column, being only 37– 45 cm (15–18 inches) in length, and weighing around 30 grams.

In its course from the base of the skull to the lumbar region, the cord gives o? 31 nerves on each side, each of which arises by an anterior and a posterior root that join before the nerve emerges from the spinal canal. The openings for the nerves formed by notches on the ring of each vertebra have been mentioned under the entry for spinal column. To reach these openings, the upper nerves pass almost directly outwards, whilst lower down their obliquity increases, until below the point where the cord ends there is a sheaf of nerves, known as the cauda equina, running downwards to leave the spinal canal at their appropriate openings.

The cord is a cylinder, about the thickness of the little ?nger. It has two slightly enlarged portions, one in the lower part of the neck, the other at the last dorsal vertebra; and from these thickenings arise the nerves that pass to the upper and lower limbs. The upper four cervical nerves unite to produce the cervical plexus. From this the muscles and skin of the neck are mainly supplied, and the phrenic nerve, which runs down through the lower part of the neck and the chest to innervate the diaphragm, is given o?. The brachial plexus is formed by the union of the lower four cervical and ?rst dorsal nerves. In addition to nerves to some of the muscles in the shoulder region, and others to the skin about the shoulder and inner side of the arm, the plexus gives o? large nerves that proceed down the arm.

The thoracic or dorsal nerves, with the exception of the ?rst, do not form a plexus, but each runs around the chest along the lower margin of the rib to which it corresponds, whilst the lower six extend on to the abdomen.

The lumbar plexus is formed by the upper four lumbar nerves, and its branches are distributed to the lower part of the abdomen, and front and inner side of the thigh.

The sacral plexus is formed by parts of the fourth and ?fth lumbar nerves, and the upper three and part of the fourth sacral nerves. Much of the plexus is collected into the sciatic nerves, the largest in the body, which go to the legs.

The sympathetic system is joined by a pair of small branches given o? from each spinal nerve, close to the spine. This system consists of two parts, ?rst, a pair of cords running down on the side and front of the spine, and containing on each side three ganglia in the neck, and beneath this a ganglion opposite each vertebra. From these two ganglionated cords numerous branches are given o?, and these unite to form the second part – namely, plexuses connected with various internal organs, and provided with numerous large and irregularly placed ganglia. The chief of these plexuses are the cardiac plexus, the solar or epigastric plexus, the diaphragmatic, suprarenal, renal, spermatic, or ovarian, aortic, hypogastric and pelvic plexuses.

The spinal cord, like the brain, is surrounded by three membranes: the dura mater, arachnoid mater, and pia mater, from without inwards. The arrangement of the dura and arachnoid is much looser in the case of the cord than their application to the brain. The dura especially forms a wide tube which is separated from the cord by ?uid and from the vertebral canal by blood vessels and fat, this arrangement protecting the cord from pressure in any ordinary movements of the spine.

In section the spinal cord consists partly of grey, but mainly of white, matter. It di?ers from the upper parts of the brain in that the white matter (largely) in the cord is arranged on the surface, surrounding a mass of grey matter (largely neurons – see NEURON(E)), while in the brain the grey matter is super?cial. The arrangement of grey matter, as seen in a section across the cord, resembles the letter H. Each half of the cord possesses an anterior and a posterior horn, the masses of the two sides being joined by a wide posterior grey commissure. In the middle of this commissure lies the central canal of the cord, a small tube which is the continuation of the ventricles in the brain. The horns of grey matter reach almost to the surface of the cord, and from their ends arise the roots of the nerves that leave the cord. The white matter is divided almost completely into two halves by a posterior septum and anterior ?ssure and is further split into anterior, lateral and posterior columns.

Functions The cord is, in part, a receiver and originator of nerve impulses, and in part a conductor of such impulses along ?bres which pass through it to and from the brain. The cord contains centres able to receive sensory impressions and initiate motor instructions. These control blood-vessel diameters, eye-pupil size, sweating and breathing. The brain exerts an overall controlling in?uence and, before any incoming sensation can affect consciousness, it is usually ‘?ltered’ through the brain.

Many of these centres act autonomously. Other cells of the cord are capable of originating movements in response to impulses brought direct to them through sensory nerves, such activity being known as REFLEX ACTION. (For a fuller description of the activities of the spinal cord, see NEURON(E) – Re?ex action.)

The posterior column of the cord consists of the fasciculus gracilis and the fasciculus cuneatus, both conveying sensory impressions upwards. The lateral column contains the ventral and the dorsal spino-cerebellar tracts passing to the cerebellum, the crossed pyramidal tract of motor ?bres carrying outgoing impulses downwards together with the rubro-spinal, the spino-thalamic, the spino-tectal, and the postero-lateral tracts. And, ?nally, the anterior column contains the direct pyramidal tract of motor ?bres and an anterior mixed zone. The pyramidal tracts have the best-known course. Starting from cells near the central sulcus on the brain, the motor nerve-?bres run down through the internal capsule, pons, and medulla, in the lower part of which many of those coming from the right side of the brain cross to the left side of the spinal cord, and vice versa. Thence the ?bres run down in the crossed pyramidal tract to end beside nerve-cells in the anterior horn of the cord. From these nerve-cells other ?bres pass outwards to form the nerves that go direct to the muscles. Thus the motor nerve path from brain to muscle is divided into two sections of neurons, of which the upper exerts a controlling in?uence upon the lower, while the lower is concerned in maintaining the muscle in a state of health and good nutrition, and in directly calling it into action. (See also NERVE; NERVOUS SYSTEM.)

Health Source: Medical Dictionary
Author: Health Dictionary
the portion of the central nervous system enclosed in the vertebral column, consisting of nerve cells and bundles of nerves connecting all parts of the body with the brain. It contains a core of grey matter surrounded by white matter (see illustration overleaf). It is enveloped in three layers of membrane, the *meninges, and extends from the medulla oblongata in the skull to the level of the second lumbar vertebra. From it arise 31 pairs of *spinal nerves.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Cordotomy

The surgical operation of cutting the anterolateral tracts of the SPINAL CORD to relieve otherwise intractable pain. It is also sometimes known as tractotomy.... cordotomy

Spermatic Cord

This comprises the VAS DEFERENS, nerves and blood vessels, and it runs from the cavity of the ABDOMEN to the TESTICLE in the SCROTUM.... spermatic cord

Umbilical Cord

The ?eshy tube containing two arteries and a vein through which the mother supplies the FETUS with oxygen and nutrients. The cord, which is up to 60 cm long, ceases to function after birth and is clamped and cut about 2·5 cm from the infant’s abdominal wall. The stump shrivels and falls o? within two weeks, leaving a scar which forms the UMBILICUS. (See also PREGNANCY AND LABOUR.)... umbilical cord

Spinal Anaesthesia

See under ANAESTHESIA.... spinal anaesthesia

Subacute Combined Degeneration Of The Cord

A degenerative condition of the SPINAL CORD which most commonly occurs as a complication of PERNICIOUS ANAEMIA. The motor and sensory nerves in the cord are damaged, causing spasticity of the limbs and an unsteady gait. Treatment is with vitamin B12 (see APPENDIX 5: VITAMINS).... subacute combined degeneration of the cord

Vocal Cords

See LARYNGOSCOPE; LARYNX; VOICE AND SPEECH.... vocal cords

Spinal Nerves

A set of 31 pairs of nerves that connect to the spinal cord. Spinal nerves emerge in 2 rows from either side of the spinal cord and leave the spine through gaps between adjacent vertebrae. The nerves then branch out to supply all parts of the trunk, arms, and legs with sensory and motor nerve fibres.

Disc prolapse may lead to pressure on a spinal nerve, causing pain. Injury to a nerve may lead to loss of sensation or movement in the area supplied by the nerve. (See also nerve injury; neuropathy.)... spinal nerves

Spinal Column

Also known as the spine, this forms an important part of the skeleton, acting both as the rigid pillar which supports the upper parts of the body and as a protection to the SPINAL CORD and nerves arising from it. The spinal column is built up of a number of bones placed one upon another, which, in consequence of having a slight degree of turning-movement, are known as the vertebrae. The possession of a spinal cord supported by a vertebral column distinguishes the higher animals from the lower types, and is why they are called vertebrates. Of the vertebrates, humans alone stand absolutely erect, and this erect carriage of the body gives to the skull and vertebral column certain distinctive characters.

The human backbone is about 70 cm (28

inches) in length, and varies little in full-grown people; di?erences in height depend mainly upon the length of the lower limbs. The number of vertebrae is 33 in children, although in adult life ?ve of these fuse together to form the sacrum, and the lowest four unite in the coccyx, so that the number of separate bones is reduced to 26. Of these there are seven in the neck, known as cervical vertebrae; 12 with ribs attached, in the region of the thorax known as thoracic or dorsal vertebrae; ?ve in the loins, called lumbar vertebrae; ?ve fused to form the sacrum; and four joined in the coccyx. These numbers are expressed in a formula thus: C7, D12, L5, S5, Coc4=33.

Although the vertebrae in each of these regions have distinguishing features, all the vertebrae are constructed on the same general plan. Each has a thick, rounded, bony part in front, known as the body, and these bodies form the main thickness of the column. Behind the body of each is a ring of bone, the neural ring, these rings placed one above another forming the bony canal which lodges the spinal cord. From each side of the ring a short process of bone known as the transverse process stands out, and from the back of the ring a larger process, the spinous process, projects. These processes give attachment to the strong ligaments and muscles which unite, support, and bend the column. The spines can be seen or felt beneath the skin of the back lying in the centre of a groove between the muscular masses of the two sides, and they give to the column its name of the spinal column. One of these spines, that of the seventh cervical vertebra, is especially large and forms a distinct bony prominence, where the neck joins the back. Between the bodies of the vertebrae lies a series of thick discs of ?brocartilage known as intervertebral discs. Each disc consists of an outer portion, known as the annulus ?brosus, and an inner core, known as the nucleus pulposus. These 23 discs provide the upper part of the spine with pliability and resilience.

The ?rst and second cervical vertebrae are specially modi?ed. The ?rst vertebra, known as the atlas, is devoid of a body, but has a specially large and strong ring with two hollows upon which the skull rests, thus allowing forward and backward movements (nodding). The second vertebra, known as the axis, has a pivot on its body which ?ts into the ?rst vertebra and thus allows free rotation of the head from side to side. The spinal column has four natural curves (see diagram) which help to cushion the shocks of walking and running.

The neural rings of the vertebrae form a canal, which is wide in the neck, smaller and almost round in the dorsal region, and wide again in the lumbar vertebrae. Down the canal runs the spinal cord, and the nerves leaving the cord do so through openings between the vertebrae which are produced by notches on the upper and lower margins of each ring. The intervertebral foramina formed by these notches are so large in comparison with the nerves passing through them that there is no chance of pressure upon the latter, except in very serious injuries which dislocate and fracture the spine.... spinal column

Adina Cordifolia

Hook. f. ex Brandis

Family: Rubiaceae.

Habitat: Indigenous in deciduous forests all over India.

English: Yellow Teak, Saffron Teak.

Ayurvedic: Haridru, Haraduaa- kadamba, Gaur-kadamba, Girikadamba, Dhaaraakadam- ba, Pitadaaru, Kadambapushpa.

Siddha/Tamil: Manjakadambu.

Folk: Haladu, Kheta Kadam.

Action: Antibacterial, antiseptic, antidysenteric, antibilious (used in biliary colic), febrifuge. Root— astringent.

The heartwood contains indole alkaloids; bark 7.27-9.27% tannin. The leaves contain ursolic acid and querce- tin.... adina cordifolia

Corday

(English) One who is well-prepared Cordaye, Cordai, Cordae... corday

Cordelia

(Latin) A good-hearted woman; a woman of honesty

Cordella, Cordelea, Cordilia, Cordilea, Cordy, Cordie, Cordi, Cordee, Cordey, Cordelle... cordelia

Cordia Myxa

Roxb. noncLinn.

Synonym: C. dichotoma Forst. f. C. obliqua Willd.

Family: Boraginaceae.

Habitat: Throughout India, wild and often planted.

English: Sabestan Plum.

Ayurvedic: Shleshmaataka, Shelu, Bahuvaara, Bahuvaaraka, Bhutvrk- shak, Uddaalaka Shita, Picchila, Lisodaa.

Unani: Sapistaan, Lasodaa.

Siddha/Tamil: Naruvili.

Action: Fruit—astringent, demulcent, expectorant, diuretic, anthelmintic, mucilaginous. Used in the diseases of the chest and urinary passage. Bark—used in dyspepsia and fevers. Kernels— externally applied to ringworm. Leaf—decoction used in cough and cold.

The fruits contain Ca 55, P 275, Zn 2, Fe 6, Mn 2, Cr 0.2 and Cu 1.6 mg/100 g (Chromium is of therapeutic value in diabetes).

Antinutritional factors are—phytic acid 355, phytate phosphorus 100 and oxalic acid 250 mg/100 g.

The seeds contain alpha-amyrin and taxifolin-3, 5-dirhamnoside, which showed significant anti-inflammatory activity. EtOH (50%) of leaves and stems—antimicrobial; aerial parts— diuretic and hypothermic.... cordia myxa

Cordia Rothii

Roem. & Schult.

Family: Boraginaceae.

Habitat: Rajasthan, Gujarat, Deccan and Karnataka.

English: Sebestan (smaller var.)

Ayurvedic: Laghu-shleshmaataka, Lisodaa.

Siddha/Tamil: Naruvili.

Folk: Gondi.

Action: See C. myxa.

Bark—astringent; decoction is used as a gargle.... cordia rothii

Cordia Wallichii

G. Don.

Synonym: C. oblique Willd. var. wallichii.

Family: Boraginaceae.

Habitat: Gujarat, North Kanara and Deccan.

English: Sebestan (bigger var.).

Ayurvedic: Shleshmaataka (bigger var.), Uddaalaka, Bahu- vaaraka.

Siddha/Tamil: Perunaruvili.

Folk: Gondi.

Action: Fruit—astringent, demulcent, expectorant. See C. myxa.... cordia wallichii

Cordillera

The mountain ridge that spans North America, from Mexico through the Rocky Mountains into Alaska.... cordillera

Cordula

(Latin / German) From the heart / resembling a jewel

Cordulah, Cordulla, Cordullah, Cordoola, Cordoolah, Cordoolla, Cordoollah... cordula

Ficus Cordifolia

Roxb.

Synonym: F. rumphii Bl.

Family: Moraceae.

Habitat: Throughout India, up to 1,700 m in the hills.

Ayurvedic: Ashmantaka (var.)

Folk: Gajanaa, Ashtaa, Paakar.

Action: Fruit juice and latex— antiasthmatic and vermifuge.

Siddha/Tamil: Kal Aal, Pei Aal.

Action: Fruit—cardiotonic. Leaves and bark—used in affections of the liver and skin diseases.... ficus cordifolia

Mikania Cordata

(Burm.) B. L. Robinson.

Synonym: M. micrantha Kunth. M. scandans Hook. f. non-Willd.

Family: Asteraceae; Compositae.

Habitat: West Bengal, eastern Assam, as a weed in tea gardens; sal and other forests and waste lands. Distributed in tropical America, Africa and Asia.

Folk: Mikaaniaa.

Action: Root—anti-inflammatory, hepatoprotective, adaptogenic.

Stigmasterol, beta-sitosterol and sesquiterpene dilactones, mikanolide, dihydromikanolide, deoxymikanolide and scandenolide have been isolated from the weed.

The root extract exhibited anti-inflammatory activity; reduced carra- geenan-induced paw oedema in experimental rats.

The methanolic extract of the root showed CNS deperssant action. It showed reduction in spontaneous motility, hypothermia, potentiation of pentobarbitone sleeping time, analgesia, suppression of aggressive behaviour and antagonism to amphetamine toxicity on experimental animals.

The methanolic extract of the root exhibited adaptogenic activity against a variety of stress-induced effects in albino rats.

The chemoprotective, anticarcino- genic and hepatoprotective effect of the methanolic extract of the root were also evaluated in animal studies. Chemical carcinogens were reduced in the liver of rats treated with the plant extract. The root extract induced recovery from carbon tetrachloride-induced damage to liver tissues in mice.... mikania cordata

Rubia Cordifolia

Linn.

Synonym: R. munjesta Roxb.

Family: Rubiaceae.

Habitat: Throughout India, ascending to an altitude of 3,700 m.

English: Indian Madder, Bengal Madder.

Ayurvedic: Manjishthaa, Vikasaa, Samangaa, Yojanavalli, Kaalameshi- ka, Raktaangi, Raktayashtikaa, Arunaa, Gandira, Jingi.

Unani: Manjeeth.

Siddha/Tamil: Manjitti.

Action: Roots and dried stem— blood purifier, astringent, diuretic, emmenagogue, deobstruent, antidysenteric, antiseptic, alterative.

The Ayurvedic Pharmacopoeia ofIn- dia recommends the use of the dried stem in blood, skin and urinogenital disorders; dysentery; piles, ulcers, inflammations; erysipelas, skin diseases and rheumatism. (Roots, leaves and seeds of R. cordifolia, R. tinctorum and allied species are used in amenorrhoea, liver diseases, gall and spleen complaints.) (Mutagenic and carcinogenic aspects of the drug are under investigation.)

It is reported that after oral administration of the root decoction, the urine and bones of the patient show a red tinge.

The roots are rich in anthraquinones and their glycosides (around 20), the important ones include purpurin (tri- hydroxy anthraquinone), munjistin (xanthopurpurin-2-carboxylic acid); besides xanthopurpurin, peudopur- purin (purpurin-3-carboxylic acid), free alizarin as well as its glucoside.

Whole plant yielded pentacylic tri- terpenic acids—rubicoumaric and ru- bifolic acids.

Antitumour cyclic hexapeptides have been isolated from the root (while lucidin is thought to be carcinogenic).

The root extracts of R. sikkimensis Kurz, known as Naaga-Madder (Nepal eastwards to Assam, Nagaland and Ma- nipur); are very similar to those of R. cordifolia.

Dosage: Stem—2-4 g. (API, Vol. III.)... rubia cordifolia

Spinal Tap

See lumbar puncture.... spinal tap

Cord

n. any long flexible structure, which may be solid or tubular. Examples include the spermatic cord, spinal cord, umbilical cord, and vocal cord.... cord

Cordectomy

n. surgical removal of a vocal cord or, more usually, a piece of the vocal cord (partial cordectomy).... cordectomy

Cordocentesis

n. the removal of a sample of fetal blood by inserting a fine hollow needle through the abdominal wall of a pregnant woman, under ultrasound guidance, into the umbilical vein. Cordocentesis is most commonly performed for confirmation of fetal *packed cell volume prior to intrauterine transfusion in cases of haemolytic disease of the newborn or for confirmation of infection in the fetus. See also fetal blood sampling.... cordocentesis

Cord Presentation

the position of the umbilical cord when it lies below the presenting part of the fetus in an intact bag of membranes. See also cord prolapse.... cord presentation

Cord Prolapse

rupture of the membranes in cases of a *cord presentation. It is an obstetric emergency: there is a severe risk of cord compression and spasm causing fetal asphyxia (see hypoxic-ischaemic encephalopathy). Delivery must occur as soon as possible and the presenting part displaced away from the cord.... cord prolapse

Cordylobia

n. see tumbu fly.... cordylobia

Sida Cordifolia

Linn.

Family: Malvaceae.

Habitat: Throughout India in moist places.

English: Country Mallow.

Ayurvedic: Balaa (yellow-flowered var.), Sumanganaa, Khara- yashtikaa, Balini, Bhadrabalaa, Bhadraudani, Vaatyaalikaa.

Unani: Bariyaara, Khirhati, Khireti, Kunayi.

Siddha/Tamil: Nilatutti.

Action: Juice of the plant— invigorating, spermatopoietic, used in spermatorrhoea. Seeds— nervine tonic. Root—(official part in Indian medicine) used for the treatment of rheumatism; neurological disorders (hemiplegia, facial paralysis, sciatica); polyuria, dysuria, cystitis, strangury and hematuria; leucorrhoea and other uterine disorders; fevers and general debility. Leaves—demulcent, febrifuge; used in dysentery.

Ephedrine and si-ephedrine are the major alkaloids in the aerial parts. The total alkaloid content is reported to be 0.085%, the seeds contain the maximum amount. In addition to alkaloids, the seeds contain a fatty oil (3.23%), steroids, phytosterols, resin, resin acids, mucin and potassium nitrate.

The root contains alkaloids—ephed- rine, si-ephedrine, beta-phenethyl- amine, carboxylated tryptamines and hypaphorine, quinazoline alkaloids— vasicinone, vasicine and vasicinol. Choline and betaine have also been isolated.

A sitoindoside, isolated from the plant, has been reported to exhibit adaptogenic and immunostimulatory activities. Alcoholic extract of the plant possesses antibacterial and antipyretic propeptide. Ethanolic extract of the plant depresses blood pressure in cats and dogs.... sida cordifolia

Nephrogenic Cord

either of the paired ridges of tissue that run along the dorsal surface of the abdominal cavity of the embryo. Parts of it develop into the kidney, ovary, or testis and their associated ducts. Intermediate stages of these developments are the *pronephros, *mesonephros, and *metanephros.... nephrogenic cord

Spinal Accessory Nerve

see accessory nerve.... spinal accessory nerve

Spinal Shock

a state of *shock accompanied by temporary paralysis of the lower extremities that results from injury to the spine and is often associated with *ileus. If the spinal cord is transected, permanent motor paralysis persists below the level of spinal-cord division.... spinal shock

Umbilical Cord Blood Banked Stem Cells

haemopoietic *stem cells collected from umbilical cord blood donated at birth, which can be stored indefinitely and used if a sibling or any other blood-compatible baby develops an illness (such as leukaemia) that could only be treated by cord-blood stem-cell transplantation. This facility is now available in the UK and the USA.... umbilical cord blood banked stem cells

Spine And Spinal Cord, Diseases And Injuries Of

Scoliosis A condition where the spine is curved to one side (the spine is normally straight when seen from behind). The deformity may be mobile and reversible, or ?xed; if ?xed it is accompanied by vertebral rotation and does not disappear with changes in posture. Fixed scoliosis is idiopathic (of unknown cause) in 65–80 per cent of cases. There are three main types: the infantile type occurs in boys under three and in 90 per cent of cases resolves spontaneously; the juvenile type affects 4–9 year olds and tends to be progressive. The most common type is adolescent idiopathic scoliosis; girls are affected in 90 per cent of cases and the incidence is 4 per cent. Treatment may be conservative with a ?xed brace, or surgical fusion may be needed if the curve is greater than 45 degrees. Scoliosis can occur as a congenital condition and in neuromuscular diseases where there is muscle imbalance, such as in FRIEDREICH’S ATAXIA.

Kyphosis is a backward curvature of the spine causing a hump back. It may be postural and reversible in obese people and tall adolescent girls who stoop, but it may also be ?xed. Scheuermann’s disease is the term applied to adolescent kyphosis. It is more common in girls. Senile kyphosis occurs in elderly people who probably have osteoporosis (bone weakening) and vertebral collapse.

Disc degeneration is a normal consequence of AGEING. The disc loses its resiliance and becomes unable to withstand pressure. Rupture (prolapse) of the disc may occur with physical stress. The disc between the fourth and ?fth lumbar vertebrae is most commonly involved. The jelly-like central nucleus pulposus is usually pushed out backwards, forcing the annulus ?brosus to put pressure on the nerves as they leave the spinal canal. (See PROLAPSED INTERVERTEBRAL DISC.)

Ankylosing spondylitis is an arthritic disorder of the spine in young adults, mostly men. It is a familial condition which starts with lumbar pain and sti?ness which progresses to involve the whole spine. The discs and ligaments are replaced by ?brous tissue, making the spine rigid. Treatment is physiotherapy and anti-in?ammatory drugs to try to keep the spine supple for as long as possible.

A National Association for Ankylosing Spondylitis has been formed which is open to those with the disease, their families, friends and doctors.

Spondylosis is a term which covers disc degeneration and joint degeneration in the back. OSTEOARTHRITIS is usually implicated. Pain is commonly felt in the neck and lumbar regions and in these areas the joints may become unstable. This may put pressure on the nerves leaving the spinal canal, and in the lumbar region, pain is generally felt in the distribution of the sciatic nerve – down the back of the leg. In the neck the pain may be felt down the arm. Treatment is physiotherapy; often a neck collar or lumbar support helps. Rarely surgery is needed to remove the pressure from the nerves.

Spondylolisthesis means that the spine is shifted forward. This is nearly always in the lower lumbar region and may be familial, or due to degeneration in the joints. Pressure may be put on the cauda equina. The usual complaint is of pain after exercise. Treatment is bed rest in a bad attack with surgery indicated only if there are worrying signs of cord compression.

Spinal stenosis is due to a narrowing of the spinal canal which means that the nerves become squashed together. This causes numbness with pins and needles (paraesthia) in the legs. COMPUTED TOMOGRAPHY and nuclear magnetic resonance imaging scans can show the amount of cord compression. If improving posture does not help, surgical decompression may be needed.

Whiplash injuries occur to the neck, usually as the result of a car accident when the head and neck are thrown backwards and then forwards rapidly. This causes pain and sti?ness in the neck; the arm and shoulder may feel numb. Often a support collar relieves the pain but recovery commonly takes between 18 months to three years.

Transection of the cord occurs usually as a result of trauma when the vertebral column protecting the spinal cord is fractured and becomes unstable. The cord may be concussed or it may have become sheared by the trauma and not recover (transected). Spinal concussion usually recovers after 12 hours. If the cord is transected the patient remains paralysed. (See PARALYSIS.)... spine and spinal cord, diseases and injuries of

Tinospora Cordifolia

(Willd.) Miers ex Hook. f. & Thoms.

Family: Menispermaceae.

Habitat: Tropical India and the Andamans.

Ayurvedic: Guduuchi, Gudu- uchikaa, Guluuchi, Amrita, Am- ritaa, Amritalataa, Amritavalli, Chinnaruuhaa, Chinnodbhavaa, Madhuparni, Vatsaadani, Tantrikaa, Kundalini. Guduuchi sattva (starch).

Unani: Gilo, Gulanchaa. Sat-e-Gilo (starch).

Siddha: Seenil, Amrida-valli.

Folk: Giloya.

Action: Herb—antipyretic, an- tiperiodic, anti-inflammatory, antirheumatic, spasmolytic, hypo- glycaemic, hepatoprotective. Water extract increases urine output. Stem juice—prescribed in high fever; decoction in rheumatic and bilious fevers. Aqueous extract of the plant—fabrifuge. Starch—antacid, antidiarrhoeal and antidysenteric.

The Ayurvedic Pharmacopoeia of India, along with other therapeutic applications, recommends the dried stems in jaundice, anaemia, polyuria and skin diseases.

The stem contains alkaloidal constituents, including berberine; bitter principles, including columbin, chas- manthin, palmarin and tinosporon, tinosporic acid and tinosporol.

The drug is reported to possess one- fifth of the analgesic effect of sodium salicylate. Its aqueous extract has a high phagocytic index.

Alcoholic extract of the stem shows activity against E. coli. Active principles were found to inhibit in vitro the growth of Mycobacterium tuberculosis.

Oral administration of alcoholic extract of the root resulted in a significant reduction in blood and urine glucose and in lipids in serum and tissues of alloxan diabetic rats. (Phytother Res. 2003 17 (4), 410-3.)

A significant reduction in levels of SGOT, SGPT, ALP and bilirubin were observed following T. cordifolia treatment during CCl4 intoxication in mature rats. (J. Toxicol Sci. 2002, 27 (3), 139-46.) The plant extract showed in vitro inactivating activity in Hepatitis- B surface antigen. (Indian Drugs, 1993, 30, 549.)

A new hypoglycaemic agent was isolated from the plant; it was found to be 1,2-substituted pyrrolidine.

The starch from roots and stem, used in chronic diarrhoea and dysentery, contains a polysaccharide having 1-4 glucan with occasional branching points.

Dosage: Stem—3-6 g powder; 2030 g for decoction. (API, Vol. I.)... tinospora cordifolia

Trichosanthes Cordata

Roxb.

Family: Cucurbitaceae.

Habitat: Foot hills of the Himalayas from Garhwal to Sikkim and in north-eastern India, up to 500 m.

Ayurvedic: Vidaari (var.), Bhuumi- kushmaanda, Patola (related species.).

Folk: Bhui-kumhraa.

Action: Tuber—dried powder given in enlarged spleen and liver; applied externally on leprous ulcers.

Used in prescriptions for haemor- rhagic diseases and in spermatopoietic tonics. Aerial parts—diuretic.

The seeds yield 23.3% (dry basis) a fatty oil containing 32.3% of punicic acid.... trichosanthes cordata

Decompression, Spinal Canal

Surgery to relieve pressure on the spinal cord or a nerve root emerging from it (see microdiscectomy). Pressure may have various causes, including a disc prolapse, a tumour or abscess of the spinal cord, or a tumour, abscess or fracture of the vertebrae. Any of these conditions can cause weakness or paralysis of the limbs and loss of bladder control.

To treat major disc prolapses and tumours, a laminectomy (removal of the bony arches of 1 or more vertebrae) to expose the affected part of the cord or nerve roots may be performed. Recovery after treatment depends on the severity and duration of the pressure, the success of the surgery in relieving the pressure, and whether any damage is sustained by the nerves during the operation.... decompression, spinal canal

Spinal Muscular Atrophy

(SMA) a hereditary condition in which cells of the spinal cord die and the muscles in the arms and legs become progressively weaker. Eventually the respiratory muscles are affected and death usually results from respiratory infection. Most affected individuals are wheelchair-bound by the age of 20 and few survive beyond the age of 30. The gene responsible has been located: in affected children it is inherited as a double *recessive. There are three forms of the disease, based on severity of the symptoms and the age at which they appear. Type 1 (infantile spinal muscular atrophy) is the most acute and aggressive form of the condition (see Werdnig–Hoffmann disease). Type 2 develops between the ages of 6 months and 2 years and type 3 (Kugelberg–Welander disease), the least severe form, appears between 2 and 17 years of age.... spinal muscular atrophy

Cordial

a stimulant and tonic.... cordial



Recent Searches