Neurinoma of the horse's tail is a tumor that originates from the nerves formed by the spinal cord's roots and collected in the so-called horse tail, which is located in the lumbar and sacral sections of the spinal canal.
The symptoms of the tumors of the horse's tail involves severe pain, later the attachment of sensory and motor disorders, asymmetry of loss of function, delay or incontinence of urine. Such uneven development of symptoms is explained by the fact that despite the displacement of the nerve roots by the tumor in the initial stages, their dysfunction develops much later.
The first symptoms of the disease are root pain, initially one-sided, then, sometimes, in some years, - bilateral. The pain is expressed significantly, increases in the underlying position and weakens when a person is standing or sitting.
Zone of pain distribution depends on the level at which the tumor appeared. If neurinoma is at the level of 2-3th lumbar vertebra, then the pain is irradiated mainly on the front of the thigh. If at the level of 4-5th vertebra, pain is felt in the perianal region and in the external genital organs. Pain in the perineum and in the area of the bladder may be exacerbated by coughing and sneezing.
Violations of sensitivity are observed quite late. The areas of surface anesthesia are located asymmetrically on the lower limbs and in the perineum. Later, violations of all kinds of sensitivity are joined. Cyanosis can develop, local temperature decreases, trophic disorders, including suction cuffs.
Deviations in the motor field are also observed at later stages and are asymmetric. With a tumor located at the beginning of the horse's tail, the disorder has all the properties of a slack peripheral paresis or paralysis with the loss of reflexes, one-way or two-way. Muscle atrophy may develop.
In the early stages of the disease, the Achilles, Stem and Anal Reflexes weaken or disappear. Characteristic is the absence of the Babinsky symptom.
Disorders of the pelvic organs are represented by disorders of urination: urinary retention or true incontinence. It is also possible to avoid incontinence and potency.
Diagnosis and treatment
Magnetic resonance imaging is widely used for instrumental diagnostics of neuron of the horse tail. The main method of treating the disease is surgical. If it is impossible to carry out a surgical operation, radiotherapy therapy is prescribed.
The prognosis depends on the stage of the oncological process and the extent of the damage surrounding the tumor of the nerve conductors. With the timely detection of a tumor, when possible its surgical removal, the prognosis is favorable.
If the compression of the nerve roots of the tumor did not lead to their atrophy, then there is a gradual restoration of sensitivity and treatment of paresis of the lower extremities.