Msana wa msana ndi mtsempha womwe umatsekera msana pamtima pa msana. Itha kukhala malo a zotupa zamitundu yosiyanasiyana, zomwe zimayambitsa kupsinjika kwa msana kumayambitsa kupweteka, kusokonezeka kwamagalimoto ndi zomverera.

Mtsinje wa medullary, womwe umatchedwanso medullary cavity, ndi mtsempha wa msana womwe uli ndi msana.

Monga chikumbutso, chingwe cha msana, kapena msana, ndi mbali ya dongosolo lapakati la mitsempha. Kutambasula kwa ubongo, chingwechi cha pafupifupi masentimita makumi anayi chimalola kufalitsa uthenga pakati pa ubongo ndi thupi, kudzera mu mitsempha ya msana yomwe imatuluka kuchokera m'mabowo odutsa.

Ngalande ya medulla imatsekereza ndikuteteza msana.

Kupsinjika kwa msana

Timalankhula za kuponderezana kwa msana pamene msana ndi mitsempha yomwe imasiyana ndi iyo imapanikizidwa ndi kuvulala. Kuponderezana kumeneku kumayambitsa kupweteka kumbuyo, kuwunikira komanso pazovuta kwambiri zamagalimoto, zomverera ndi sphincter.

Chotupa chomwe chimayambitsa kuponderezedwa chikhoza kukhala kunja kwa msana (chotupa cha extramedullary) kapena mkati (chotupa cha intramedullary) ndikukhala, kutengera chikhalidwe chake, pachimake kapena chosachiritsika. Zitha kukhala:

• chimbale cha herniated 
• subdural kapena epidural hematoma pambuyo pa kuvulala komwe kunayambitsa kuvulala kwa ligament kapena fupa, kubaya m'chiuno, kutenga anticoagulant.
• kuthyoka, kupanikizana kwa vertebral ndi zidutswa za fupa, kusokonezeka kwa msana kapena kusakanikirana
• chotupa (makamaka metastatic extramedullary chotupa)
• neuroma, meningioma
• chotupa
• kupsinjika kwa mafupa chifukwa cha osteoarthritis
• kuwonongeka kwa arteriovenous
• cervicarthrosis myelopathy

Cauda Equina Syndrome

Dera la msana lomwe lili pamtunda wa lumbar vertebrae yomaliza ndi sacrum, komwe kumatuluka mizu yambiri ya mitsempha yolumikizidwa ndi miyendo yapansi ndi sphincters, imatchedwa ponytail.

Pamene kuponderezedwa kwa msana kumakhala pamtunda wa ponytail iyi, nthawi zambiri chifukwa cha diski ya herniated, kungayambitse matenda a cauda equina. Izi zimawonetseredwa ndi ululu m'munsi, kupweteka m'dera la perineum ndi m'miyendo yapansi, kutaya kumverera, kufa ziwalo ndi matenda a sphincter. Izi ndizovuta zachipatala. 

The medullary infarction

Kawirikawiri, chotupa chomwe chili pa chiyambi cha kupsyinjika kwa msana chimachepetsa mitsempha ya mitsempha, kenako imatsogolera ku medullary infarction.

Opaleshoni

Opaleshoni ndi njira yokhazikika yochizira kupsinjika kwa msana. Kuchitapo kanthu, komwe kumatchedwa laminectomy, kumaphatikizapo kuchotsa mbali yapambuyo ya vertebra (kapena tsamba) pafupi ndi chotupacho, ndikuchichotsa kuti chiwononge mafuta ndi mizu yake. Kuchitapo kanthu kumeneku kumapangitsanso kusanthula zilondazo.

Pankhani ya cauda equina syndrome, opaleshoniyi ya decompression iyenera kuchitika mwachangu kuti apewe zovuta zamagalimoto, zomverera, sphincter ndi sequelae yogonana.

Ngati chotupa chomwe chimayambitsa kupsyinjika kwa msana ndi hematoma kapena abscess, izi zidzachotsedwa opaleshoni.

Radiotherapy

Ngati chotupa cha khansa, radiotherapy nthawi zina imaphatikizidwa ndi opaleshoni.

Kuyesedwa kwachipatala

Poyang'anizana ndi motor, sensory, sphincter kapena kupweteka kwadzidzidzi kwa msana, ndikofunikira kuti mufunsane mosazengereza. Wodwalayo ayambe kuchita kafukufuku wachipatala kuti atsogolere matendawa malinga ndi zizindikiro ndi palpation ya msana.

MRI

MRI ndiye muyezo wagolide wa msana. Zimapangitsa kuti zitheke kupeza malo a kupsyinjika kwa msana ndi kutsogolera ku matenda oyamba okhudzana ndi chikhalidwe cha zilondazo. Kutengera ndi zomwe zikuwonetsa pakuwunika, jakisoni wa Gadolinium atha kuchitidwa.

CT myelography

Pamene MRI sizingatheke, CT kapena CT myelography ikhoza kuchitidwa. Kuwunikaku kumakhala ndi kubaya mankhwala opacifying mu ngalande ya msana kuti athe kuwona mawonekedwe a msana pa x-ray.

X-ray ya msana

Ngati fupa la fupa likukayikira, ma X-ray a msana amatha kutengedwa kuwonjezera pa MRI.

Medullary arteriography

Nthawi zina, arteriography imatha kuchitidwa kuti ayang'ane zilonda zam'mitsempha. Zimapangidwa ndi jekeseni, pansi pa anesthesia wamba, chinthu chosiyana ndikujambula zithunzi zingapo panthawi ya mitsempha ya mitsempha ndi mitsempha ya mankhwalawa.