Spine, Nerve structure - Meninges

Within the spinal canal, the spinal cord is surrounded by the EPIDURAL SPACE. This space is filled with fatty tissue, veins, and arteries. The fatty tissue acts as a shock absorber and keeps the spinal cord from contacting the bony tissue of the vertebrae.

The brain and spinal cord are covered by three layers of material, called Meninges. The main function of these layers is to protect and feed the delicate neurological structures.

The DURA MATER is the outermost meningeal layer and is made up of strong connective tissue. Also called the DURA, it is gray in color and generally easy to identify within the spinal canal. The dura extends around each nerve root and becomes contiguous with the EPINEURUM, a membrane covering the spinal nerves

The SUBDURAL SPACE is a very small space between the dura and the next meningeal layer, the ARACHNOID. The arachnoid layer is highly vascularized with a web of arteries and veins that give the impression of a spider wed. It is thinner than the dura and is subject to injury.

Below the arachnoid is the SUBARACHNOID SPACE, which is filled with CEREBROSPINAL FLUID (CSF). The CSF helps to protect the nerve structures by acting as a shock absorber. It also contains various electrolytes, protect, and glucose. A spinal tap can be inserted into the subarachnoid space to retrieve CSF for various chemical analyses.

The innermost lining of the meninges is called the PIA MATER. It is closely adhered to the spinal cord and the individual nerve roots. It is highly vascular and supplies blood to the neuro-logical structures.

Reference: http://www.back.com/

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

Are there any screening tools to help diagnose neuropathic pain?

Various screening tools are available to help physicians diagnose neuropathic pain. The European Federation of Neurological Societies (EFNS) has recently published updated guidelines that provide an overview of, and recommendations on, the key screening tools. These tools are: the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)2; Neuropathic Pain Questionnaire (NPQ)3; Douler Neuropathique en 4 questions (DN4)4; PainDETECT5; ID Pain6; and the standardized evaluation of pain (StEP)7. All these screening tools have been validated in various neuropathic pain populations; the LANSS, DN4 and StEP utilize interview questions and physical examination, while the NPQ, PainDETECT and ID Pain use only interview questions. Of relevance to the Hong Kong population, one of the screening tools – the ID Pain – has been translated to and validated. The validity of the 6-item patient-completed questionnaire was assessed in 92 patients with either neuropathic or nociceptive pain. At a score of 3 or more, the questionnaire correctly classified 71% of cases. While screening tools are useful for identifying patients with possible neuropathic pain, particularly by non-specialist physicians, they do have limitations. As noted in the EFNS guidelines, these tools fail to identify 10–20% of patients with physician-diagnosed neuropathic pain; hence, they should be used together with a thorough patient history and physical examination.

ID pain

1 Did the pain feel like pins and needles? 您的痛楚是否好像被針刺般疼痛？

2 Did the pain feel hot/burning? 您的痛楚是否灼熱或好像被火燒一樣？

3 Did the pain feel numb? 您的痛楚是否帶有麻痺？

4 Did the pain feel like electrical shocks? 您的痛楚是否好像觸電一樣？

5 Is the pain made worse with the touch of clothing or bedsheets? 您的痛楚是否因觸碰衣服或床單而加劇？

6 Is the pain limited to your joints? 您的痛楚是否只限於關節部位？

Reference: http://www.neuropainhk.org

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your doctor immediately.

What is neurosurgery? And what is the neurosurgeon do?

Neurosurgery is a specialty of surgery which provides the critical care, prevention, diagnosis, evaluation, treatment, and rehabilitation of neurological disorders. This includes the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify the function or activity of the nervous system, including the hypophysis and the operation and non-operative treatment of pain. As such, neurosurgery encompasses treatment of adult and pediatric patients with disorders of the nervous system: disorders of the brain, meninges, and the skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland, disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

What is neurosurgeon?

Neurosurgeon is a surgical doctor specialized in neurological disorders.

Central Nervous System (CNS) disorders - Stroke, Parkinsonism disease, Dementia, Brain tumors, Acoustic neuroma, Arteriole-venous malformation (AVM), etc...

Peripheral Nervous System (PNS) disorders – like Back pain, Scoliosis, Sciatica, Low back pain, Neck pain, Neuropathic pain, etc…  .

Reference information: www.brain-spine.com.hk, http://www.surgery.cuhk.edu.hk/neuro/default.htm

The information above is used for educational purpose only, for any enquiries, please consult your neurosurgeon for medical advices.