1. What is the role of extra medullary tumor leading to spinal cord injury?

Ascending and Descending Spinal Tracts

The nerves in the spinal cord are bundled together as Ascending and Descending tracts. Ascending tracts within the spinal cord carry sensory information from the body, upwards to the brain, such as touch, skin temperature, pain and joint position. Descending tracts within the spinal cord carry information from the brain downwards to initiate movement and control body functions.

Spinal Nerves
Nerves called the spinal nerves or nerve roots, branch off the spinal cord and pass out through a hole in each of the vertebrae called the Foramen. These nerves carry information from the spinal cord to the rest of the body, and from the body back up to the brain. There are four main groups of spinal nerves, which exit different levels of the spinal cord. These are in descending order down the vertebral column: Cervical Nerves "C" : (nerves in the neck) supply movement and feeling to the arms, neck and upper trunk. Also control breathing. Thoracic Nerves "T" : (nerves in the upper back) supply the trunk and abdomen. Lumbar Nerves "L" and Sacral Nerves "S" : (nerves in the lower back) supply the legs, the bladder, bowel and sexual organs.

Spinal Tumors
Tumors may grow in the different sites of the spinal column. I t becomes affected not only because of the growth of the tumor but also with the compression it has on the location. The classifications of the tumor are related to their location in the dura and the spinal cord. The major classifications are extradural (arises from the bone of the spinal column) and intradura (tumor growth in the dura matter). Intradural tumor are further subdivided into extramedullary (in between the spinal cord and the dura matter) and intramedullary (spinal cord).

Intradural-Extramedullary (inside the dura) tumors grow within the spinal canal (under the membrane that covers the spinal cord) but outside of the nerves. Usually these tumors are benign and slow growing. However, they can cause symptoms of pain and weakness. Most of these spinal tumors are:

Meningiomas that occur in the membranes surrounding the spinal cord and are usually benign but may be malignant. These tumors are more common in middle age and elderly women. Nerve sheath tumors (schwannomas and neurofibromas) that arise from the nerve roots that come off the spinal cord. Again, this type of tumor is usually benign and slow growing, and it may be years before any neurological problems occur. The growing tumor will obstruct the blood flow to the gray matter. It will result to hypoxia of the dura matter. This condition stimulates the release of catecholamines which are contributing agents to necrotize the area thus, resulting to disintegration and dissociation of the fibers. Signs and sypmtoms will be dependent on the rate of tumors growth and area affected.