The spinal cord consists of a tubular continuation of the brain together with this in three membranes, the dura mater externally, the arachnoid, and internally, the pia mater. Sub-arachnoid space is between the arachnoid and pia mater, filled with Cerebro-spinal fluid. The material of the cord consists of white matter externally and grey matter internally. The spinal cord passes through the neural canal of the vertebral column. Injuries to vertebral bodies and inter-vertebral discs may affect the spinal cord. Due to any direct or indirect-trauma to the cord it is inflamed and softened at the affected part, and may be haemorrhagic.
Injuries of bony and neural content of the vertebral spine often coexist. It may be in the form of simple injury and extend to deformity. Mostly spinal cord injuries follow subluxation with or without rotary motion of the nearby vertebra which compress the spinal cord between the dislocated bones. Often the prolapsed inter-vertebral disc may also damage the spinal cord by putting abundant pressure on it. In older age groups degenerative arthritis of the cervical spine may also affect the spinal cord. The spinal cord may be trapped between the bony spars interiorly and ligamentum flavum, posteriorly. The distribution of oedema, haemorrhage and infarction produces the neurological symptoms. Contusion or laceration of the spinal cord is the result of any bony injury. This may cause oedema, haemorrhage, cell hypoxia and further degeneration.
Compression of the spinal cord is most commonly due to vertebral caries and injuries, together with fractures. In vertebral caries the stress results from the accumulation of pus and caseous material between the bone and dura.
Neuralgic pain is the foremost symptom, due to compression of nerve roots, radiating the length of the affected nerves and accompanied by hyperesthesia and followed by anesthesia. When anterior by them. It causes narrowing of the cord with myelitis at the site of compression. Paralysis of gradual onset, anesthesia, increased reflexes and spastic rigidity are other subsequent symptoms of anterior root compression. In caries and traumatic lesion, curvature of the spine may be deformed and tenderness is usually resent over the vertrbral column. In vertebral column injuries and spinal cord lesions kshipra, talahridaya, kurca, kurcasira, gulpha, indravasti, janu, urvi, ani marma of contra lateral and affected leg should be treated with rubbing, pressure, oil massage, paste application and fomentation. The vasti-chikitsa and marma shaiya offer a very promising option for these patients.