How serious is a spinal cord injury? | Neurology

Spinal cord injury (SCI)

What is spinal cord injury?

A spinal cord injury – harm to any aspect of the spinal cord or the nerves toward the finish of the spinal canal (cauda equina) – frequently causes lasting changes in quality, sensation, and other body capacities underneath the site of the injury.

If you have recently had a spinal cord injury, it may seem like every aspect of your life has been affected. You may feel the effects of your injury mentally, emotionally, and socially.

Numerous researchers are hopeful that propels in the examination will some time or another make fix of spinal cord injuries conceivable. The examination considers are in progress around the world. Then, medicines and recovery permit numerous individuals with SCI to lead gainful and autonomous lives.

Symptoms of spinal cord injury

Some of the symptoms of a spinal cord injury may include:

  • Problems with walking
  • Loss of bladder or bowel control
  • Inability to move arms or legs
  • Feeling of numbness or tingling in the extremities
  • Unconsciousness
  • Headache
  • Pressure, Pain, and stiffness in the back or neck
  • Signs of shock
  • Abnormal head position

What are the causes of spinal cord injury?

The most widely recognized reason for a spinal cord injury is trauma. Almost half of the injuries are caused by car accidents. Other types of trauma include:

  • Falls from heights,
  • Violence (stab wounds or gunshot wounds to the spine), and
  • Sports injuries (diving, football, rugby, equestrian, etc.).

Spinal cord injury can also be caused by cord compression due to a tumor, infection, or inflammation. Some patients have a smaller than normal spinal canal (called spinal stenosis) and are at higher risk of spinal cord injury.

All tissues of the body, including the spinal cord, require a good supply of blood to deliver oxygen and other nutrients. Failure of this blood to reach the spinal cord can result in a spinal cord injury. This can be caused by an aneurysm (distended blood vessel), compression of a blood vessel, or prolonged low blood pressure.

How are spinal cord injuries diagnosed?

The emergency room doctor will test the individual to see if there is any movement or sensation at or below the injury level. Methods for assessing autonomic function have also been developed (American Spinal Injury Association, or ASIA, Autonomic Criteria Classification). Include emergency medical examinations for a spinal cord injury:

  • Magnetic resonance imaging (MRI), which uses computer-generated radio waves and a strong magnetic field to produce detailed, 3D images of body structures, including tissues, organs, bones, and nerves. It can document brain and spinal injuries from injuries, as well as help, diagnose brain and spinal cord tumors, herniated discs, irregular blood vessels (blood vessels), bleeding and infections that may put pressure on the spine and spinal cord, and injury to the ligaments that support the cervical spine.
  • A computerized tomography (CT) scan provides fast, clear 2D X-ray images of organs, bones, and tissues. A CT scan of the nerves is used to view the brain and spine. CT scanning is excellent at detecting bone fractures, bleeding, and spinal stenosis (narrowing of the spinal canal), but CT scanning has less ability to image the spinal cord or identify ligament injury associated with an unstable spine compared to MRI.
  • X-rays (which show the levels of bone over the bones) of a person’s chest and skull are often taken as part of a neurological examination. X-rays can be used to see most parts of the body, such as a joint or a major organ system. In conventional x-rays, a focused batch of low-dose ionizing radiation is passed through the body onto a photographic plate. Since calcium in the bones absorbs X-rays more easily than soft tissues or muscles, the bone structure appears white on the film. Spinal misalignment or fracture can be seen within minutes. X-rays are taken in different positions of the neck (i.e. displays of flexion and extension) to detect instability of the cervical spine. Tissue lumps such as injured ligaments or disc bulging cannot be seen on conventional X-rays.

Complications

At first, the changes in the way your body works can be massive. However, your rehabilitation team will help you develop the tools you need to deal with the changes caused by a spinal cord injury, as well as recommend equipment and resources to enhance the quality of life and independence. Often affected areas include:

  • Bladder control: Your bladder will keep on putting away pee from your kidneys. However, your brain may not be able to control your bladder as well due to an injury to the message carrier (spinal cord).

Changes in bladder control increase the risk of developing a urinary tract infection. The changes may also lead to kidney infections and kidney or bladder stones. During the restoration, you’ll learn new strategies to help void your bladder.

  • Bowel control: Although your stomach and intestines function a lot as they did before the injury, the control of your bowel movements often changes. A diet rich in fiber may help regulate your bowel movement, and you’ll learn techniques to improve bowel function during rehab.
  • Skin sensation: Below the nerve level of your injury, you may have lost part or all of the sensation of the skin. Therefore, your skin cannot send a message to your mind when it is hit by certain things like prolonged stress, heat, or cold.

This may make you more likely to develop pressure sores, but changing positions frequently – with help, if needed – can help prevent these sores. You will learn proper skin care during rehabilitation, which can help you avoid these problems.

  • Control of blood circulation: A spinal cord injury may cause circulatory problems ranging from low blood pressure when elevated (orthostatic hypotension) to swelling of your limbs. These changes in blood circulation may also increase the risk of blood clots, such as deep vein thrombosis or a pulmonary embolus.

Another problem with circulatory control is potentially life-threatening high blood pressure (autonomic hyperreflexia). Your rehabilitation team will teach you how to treat these issues if they affect you.

  • Respiratory system: Your injury may make breathing and coughing worse if the stomach and chest muscles are affected. This includes your diaphragm and the muscles of your chest wall and abdomen.

The level of nerve injury will determine the type of breathing problems you may have. If you have an injury to the cervical and thoracic spinal cord, you may be at increased risk of developing pneumonia or other lung problems. Medicines and therapy can help prevent and treat these problems.

  • Muscle strength: Some people with spinal cord injuries experience one of two types of muscle tension problems: uncontrolled tension or movement in muscles (spasticity) or soft and limp muscles that lack muscle tension (relaxation).
  • Fitness and wellness: Weight reduction and muscle atrophy are regular not long after a spinal cord injury. Limited mobility can lead to a more sedentary lifestyle, which puts you at risk of obesity, cardiovascular disease, and diabetes.

A dietitian can help you eat a nutritious diet to maintain an adequate weight. Physical and occupational therapists can assist you in building up a wellness and exercise program.

  • Sexual health: Sexual life, fertility, and sexual function may be affected by a spinal cord injury. Men may notice changes in erection and ejaculation. Women may notice changes in lubrication. Doctors who specialize in urology or fertility surgery can offer options for sexual performance and fertility.

Some people experience pain, such as muscle or joint pain, due to the overuse of certain muscle groups. Nerve pain can occur after a spinal cord injury, especially in a person with an incomplete injury. Dealing with all the changes that a spinal cord injury brings and living with pain causes some people to become depressed.

Spinal cord injury treatment

Treatment for SCI begins before the patient is admitted to the hospital. Paramedics or other EMS personnel carefully stabilize the entire spine at the scene of the accident. In the emergency department, this freeze continues while more serious, life-threatening problems are identified and addressed. If the patient must undergo emergency surgery due to trauma to the abdomen, chest, or other areas, the stability of the spine and alignment of the spine is maintained during the operation.

Non-Surgical Treatments

If the patient has an SCI, they are usually admitted to the intensive care unit (ICU). For some cervical spine wounds, footing might be shown to help bring the spine into an appropriate arrangement. Standard intensive care unit care, including maintaining stable blood pressure, monitoring cardiovascular function, ensuring adequate ventilation and lung function, prevention and prompt treatment of infection, and other complications, is basic so SCI patients can accomplish the most ideal result.

Surgery

Sometimes the surgeon may want to take the patient to the operating room immediately if the spinal cord appears to be compressed by a herniated disc, blood clot, or other lesions. This is generally regular in patients with deficient SCI or with reformist neurological decay. Regardless of whether medical procedure can’t invert the harm to the spinal cord, medical procedure might be expected to balance out the spine to forestall future agony or disfigurement. The surgeon will decide which procedure will provide the most benefit to the patient.

Follow-up

Neurologically, people with complete quadriplegia have a high risk of developing secondary medical complications, including pneumonia, pressure ulcers, and deep venous thrombosis. Pressure ulcers are the most noticeable complication, starting with 15% during the first year after infection and increasing steadily thereafter.

Restoration of function depends on the severity of the initial injury. Unfortunately, those with a complete SCI are unlikely to regain function below the level of the injury however, if there is some degree of improvement, it usually establishes itself within the first few days after the accident.

Incomplete injuries as a rule give some level of progress after some time, however, this differs from the kind of injury. Although full recovery may be unlikely in most cases, some patients may be able to get better at least enough to move and control bowel and bladder function.

Once the patient’s condition has stabilized, care, and treatment focus on supportive care and rehabilitation. All family members or specially trained nurses or aides may provide supportive care. This care may include helping the patient to bathe, dress, and change positions to prevent bedsores and other forms of assistance.

Restoration frequently incorporates physical therapy, occupational therapy treatment, and guiding for enthusiastic help. Services may be provided initially while the patient is hospitalized. After admission to the hospital, some patients are admitted to the rehab facility. Other patients may pursue rehabilitation on an outpatient basis and/or at home.

What’s the long-term outlook?

A few people lead full and beneficial carries on with after a spinal cord injury. However, there are potentially dire effects of spinal cord injury. The vast majority of people will need assistive devices such as walkers or wheelchairs to deal with motion loss, and some may be paralyzed from the neck down.

You may need help with activities of daily living and learn to perform tasks differently. Pressure sores and urinary tract infections are normal intricacies. You may also expect to undergo intensive spinal cord injury rehabilitation treatment.

Risk factors

Although a spinal cord injury is usually the result of an accident and can happen to anyone, some factors may put you at a higher risk for a spinal cord injury, including:

  • To be a male: Spinal cord injuries influence an unbalanced number of men. Actually, females represent just about 20% of horrible spinal cord injuries.
  • Being between 16 and 30 years old: You are more likely to suffer a traumatic spinal cord injury if you are between the ages of 16 and 30. The normal age at the hour of injury is 43 years.
  • Being over the age of 65: Falls cause most injuries in the elderly.
  • Engaging in risky behavior: Diving in shallow water or exercising without wearing the appropriate safety equipment or taking appropriate precautions can result in spinal cord injuries. Car collisions are the main source of spinal cord injury for individuals younger than 65.
  • Having a bone or joint disorder: A relatively minor injury can cause a spinal cord injury if you have another disorder that affects your bones or joints, such as osteoarthritis or osteoporosis.

How can I prevent spinal cord injuries?

Since spinal cord injuries are often the result of unexpected events, the best thing you can do is to reduce your risk. Some risk reduction measures include:

  • Always wear a seat belt while you are in the car
  • Wear appropriate protective clothing while playing sports
  • Never dive into water unless you check it first to make sure it is deep enough and free of rocks

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