Spinal Cord Injury
The spinal cord is a bundle of nerves and other tissue that the vertebrae of the spine contains and protects. The vertebrae are the bones stacked on top of each other that make up the spine. The spine contains many nerves, and extends from the brain’s base down the back, ending close to the buttocks. These nerves that leave the spinal cord and go reach arms, legs, chest and abdomen. These nerves allow brain to give commands to muscles and cause movements of your limbs. The nerves also control the function of your organs including your heart, lungs, bowels, and bladder.
Spinal cord is most sensitive structure. Unlike other organs of the body spinal cord does not have ability to repair, if it is damaged. Causes for spinal cord injury are tumors, infections and trauma. Of these most common cause is spinal trauma. Most common mode of spinal trauma is Road traffic accidents and fall from heights. The initial blunt force damages spinal nerve cells. However, in the hours and days after injury a cascade of secondary events, like release of toxic chemicals at the site of injury, further damage the cord.
The symptoms of spinal cord injury depend on where the spinal cord is injured and whether or not the injury is complete or incomplete. Spinal cord injury presents with paralysis below the level of injury. In incomplete injuries, patients have some function below the level of injury, while in complete injuries they have no function below the level of injury. Injuries to the spinal cord can also cause loss of sensation in the body below the level of injury, loss of control of the bowels and bladder, and loss of normal sexual function. Spinal cord injuries in the upper neck can cause difficulty breathing and may require the use of a breathing machine, or ventilator.
Spinal cord injury identified by clinical examination and radiological investigations like x ray, CT scan and MRI. These investigations helps in identifying level of injury and its severity
The first step in treatment of a suspected spinal cord injury is to verify the patient is breathing and the heart is beating. A spinal cord injury in the upper neck can cause a loss of control of normal breathing. This may require ventilator. The next step in treatment of a spinal cord injury is immobilization. This often occurs at the time of injury prior to being transported to the hospital. Emergency technicians may place the patient in a cervical collar or on a backboard to help prevent the spine from moving. If the patient has a spinal cord injury, further movement of the spine could lead to further damage.
Some patients with spinal cord injury may also require surgery. Surgery includes stabilization of spinal column with rods and screws decompressing the spinal cord. Prognosis of the surgery after spinal cord injury depends on level of injury, severity of injury and time of presentation after injury. The injuries at the lumbar area tend to fare better than the other areas of the spine.
Surgery usually helps the patients to mobilize early so that the delayed complications like bed sores and lung problems are avoided
Rehabilitation is most important in managing patients with spinal cord injury, this help the patient improve their function through physical and occupational therapy and the use of assistive devices.