Spine Disorders
WHEN TO SEE A SPINE SPECIALIST You should
seek the advice of a spine specialist if neck or back pain persists for more
than two weeks or if it is progressive in intensity and/or distribution. You
should seek prompt medial advice if you develop rapid onset extremity pain,
numbness, tingling or weakness. You should seek immediate healthcare attention
if neck or back pain occurs as the result of an injury or if it is associated
with serious illness and/or a high fever. Additional signs and symptoms which
warrant prompt medical attention include:
SCREENING AND DIAGNOSIS Physicians diagnose transverse myelitis by taking a medical
history and performing a thorough neurological examination. Because it is often
difficult to distinguish between a patient with an idiopathic form of
transverse myelitis and one who has an underlying condition, physicians must
first eliminate potentially treatable causes of the condition. If a spinal cord
injury is suspected, physicians seek first to rule out lesions (damaged or abnormally
functioning areas) that could cause spinal cord compression. Such potential
lesions include tumors, herniated or slipped discs, stenosis (narrowing of the canal
that holds the spinal cord), and abscesses. To rule out such lesions and check
for inflammation of the spinal cord, patients often undergo magnetic
resonance imaging (MRI), a procedure that provides a picture of the brain and
spinal cord. Physicians also may perform myelography, which involves
injecting a dye into the sac that surrounds the spinal cord. The patient is
then tilted up and down to let the dye flow around and outline the spinal cord
while X-rays are taken. Blood tests may be performed to rule out various disorders such as
systemic lupus erythematosus, HIV infection, and vitamin B12 deficiency. In
some patients with transverse myelitis, the cerebrospinal fluid that bathes the
spinal cord and brain contains more protein than usual and an increased number
of leukocytes (white blood cells), indicating possible infection. A spinal tap
may be performed to obtain fluid to study these factors. If none of these tests
suggests a specific cause, the patient is presumed to have idiopathic
transverse myelitis. |