Spinal Ischemic Diseases

　　Cervical ischemia can occur during the interference with blood supply during aortography or the surgical resection of an aortic aneurysm. Sometimes it can be caused by atherosclerosis of the aorta, spinal vascular malformation, microembolism, vasospasm, and insufficient blood supply. Other causes include syphilitic spinal arteritis, lumbar spinal stenosis, spinal trauma, polycythemia, venous thrombosis, and low blood pressure caused by systemic diseases, all of which can lead to cervical ischemia.

　　A series of injurious biochemical changes caused by cervical ischemia will lead to intracellular calcium accumulation, increased content of oxygen free radicals, thereby damaging the neurons in the spinal cord, causing irreversible damage to the spinal cord function. Foreign scholars have found apoptotic bodies in damaged neurons in the rabbit spinal cord ischemia model, suggesting that apoptosis promotes the death of nerve cells.

　　The complications of cervical ischemic diseases are mainly the manifestations of the primary diseases outside the spinal cord, such as complications related to atherosclerosis, as well as secondary pneumonia, bedsores, urinary tract infections, and other complications caused by progressive paraplegia and bed rest.

　　Cervical ischemia occurs in atherosclerosis of the aorta. Cervical transient ischemic attack (TIA) manifests as sudden paraplegia, lasting for several tens of minutes or several hours and then completely recovering; if several segments of the spinal cord are completely occluded, then paraplegia, complete loss of sensation, and dysuria and fecal incontinence occur.

　　Examinations needed for spinal ischemic diseases:

　　1. Cerebrospinal Fluid Examination:Spinal subarachnoid hemorrhage CSF is hemorrhagic; when there is spinal canal obstruction, CSF protein levels increase and pressure is low.
　　2. MRI:It can show local thickening, hemorrhage, or infarction of the spinal cord, and after enhancement, vascular malformations may be found. Myelography can determine the location of the hematoma and show the location and range of the malformed vessels on the surface of the spinal cord, but cannot distinguish the type of lesion.
　　3. Spinal Digital Subtraction Angiography (DSA):It is of great value in diagnosing spinal vascular malformations, as it can clearly show the size, shape, location, range, type, supplying arteries, and draining veins of the malformed vessels, which is very helpful for guiding surgical or radiological intervention treatment.

　　Patients should pay attention to strengthening their nutrition, eating more high-protein, high-vitamin, and fiber-rich foods to improve the body's tissue repair capacity; avoid high-salt and high-fat foods to prevent high blood viscosity, which may further worsen ischemic symptoms; avoid spicy and warm foods such as alcohol, chili, dried ginger, pepper, cinnamon, etc.; avoid drinking alcohol, strong tea, coffee, and other irritant foods.

　　Spinal ischemic diseases are similar to ischemic cerebrovascular diseases, and vasodilators and substances promoting nerve function should be used. Hypotensive patients should correct their blood pressure, and analgesic and sedative agents can be given to those with pain.

　　Treatment Principles
　　The treatment principles for spinal ischemic and hemorrhagic diseases are different in the early stage of the disease. Ischemic treatment mainly focuses on promoting blood circulation and removing blockages, while hemorrhagic diseases with signs of spinal cord compression should strive for surgical treatment as early as possible. If it is subarachnoid hemorrhage, hemostasis should be the main treatment. In the recovery period of spinal ischemic and hemorrhagic diseases, the principles of acupuncture treatment are the same, aiming to regulate Qi and promote blood circulation, relax tendons and remove blockages, and combine with functional exercises.