Spinal cord injury treatment is directly connected with treating the damages in spinal bone and neuron system of the body. This injury can lead to partial or complete paralysis. Treatment of spinal cord injury may involve medication, surgery or both and always include physical therapy. The spinal injury happen due to either traumatic or non traumatic causes. In traumatic spinal injury like accidents, immediate and comprehensive trauma care is crucial for both survival and long term results.A competent trauma team try their level best to minimize the spread of damage from a spinal cord injury. Non traumatic causes of spinal injury occur over time and include arthritis, cancer, infection, blood vessel problems, bleeding and inflammation. The long-term prognosis for a spinal cord injury depends on the nature and location of the injury, as well as the quality of care received.
Different surgical treatments are conducted to cure the spinal cord injury
- Laser spine surgery – It is a minimal invasive endoscopic procedure that does not require any cutting or disturbing of the muscles and bones. Surgical lasers are typically used to remove (ablate) unwanted or abnormal tissue
- Cervical Spine Surgery – This involves removing a cervical herniated disc in order to relieve spinal cord or root pressure to alleviate corresponding pain
- Total Disc Replacement –Through this procedure a mechanical device is substituted for an intervertebral disk in the spine
- Lumbar Spinal Stenosis Surgery – This procedure is done for narrowing the spinal canal in the lower back, known as the lumbar area
It is the cylindrical bundle of nerve fibres and associated tissue which is enclosed in the spine and connects nearly all parts of the body to the brain, with which it forms the central nervous system. he spinal column, more commonly called the backbone, is made up primarily of vertebrae, discs, and the spinal cord. Acting as a communication conduit for the brain, signals are transmitted and received through the spinal cord.
When an injury to the spinal cord occurs the flow of information from that point down is stopped. This break in instructions to the arms, legs, and other parts of the body will prevent the individual from moving, sometimes breathing, and obstructs or stops any sense of feeling or touch. The function of the organs such as lungs, heart, bladder and bowels are also controlled by these nerves.
What is Spinal Cord Injury
A spinal cord injury (SCI) is damage to the spinal cord that causes changes in its function, either temporary or permanent. These changes translate into loss of muscle function, sensation, or autonomic function in parts of the body served by the spinal cord below the level of the lesion. Gunshot, car accident and sport injuries are the traumas that can cause damage to the spinal cord. Polio, Spina Bifida, Transverse Myelitis and Friedreich’s Ataxia are the diseases that can cause damage to the spinal cord.
Types of Spinal Cord Injury (SCI)
There are two types of spinal cord injuries. Complete spinal cord injuries refer to the types of injuries that result in complete loss of function below the level of the injury, while incomplete spinal cord injuries are those that result in some sensation and feeling below the point of injury. The level and degree of function in incomplete injuries is highly individual, and is dependent upon the way in which the spinal cord has been damaged.
Complete Spinal Cord Injury
Complete spinal cord injuries result in complete paraplegia or complete tetraplegia.
Complete paraplegia is described as permanent loss of motor and nerve function at T1 level or below, resulting in loss of sensation and movement in the legs, bowel, bladder, and sexual region. Arms and hands retain normal function.
Some people with complete paraplegia have partial trunk movement, allowing them to stand or walk short distances with assistive equipment. In the majority of cases, complete paraplegics choose to get around via a self-propelled wheelchair.
Complete tetraplegia is characterized by the loss of hand and arm movement as well. Some tetraplegics require ventilator systems in order to breathe. Depending upon the location of the injury, some tetraplegics may have some arm and hand movement present
Incomplete Spinal Cord Injury
Incomplete spinal cord injuries are more common than complete injuries, and are characterized by some degree of sensation and movement below the point of injury. Incomplete spinal injuries can result in some feeling but little or no movement, or in some movement but little or no feeling. Incomplete spinal injuries fall under five different classifications
- Anterior Cord Syndrome
- Central Cord Syndrome
- Posterior Cord Syndrome
- Brown-Sequard Syndrome
- Cauda Equina Lesion
Symptoms of Spinal Cord Injury
symptoms of a spinal cord injury include:
- problems walking.
- loss of control of the bladder or bowels.
- inability to move the arms or legs.
- feelings of spreading numbness or tingling in the extremities.
- pain, pressure, stiffness in the back or neck area.
- signs of shock.
Symptoms of Spinal Cord Injury after an Accident
- Emergency symptoms of an injury include
- severe pain or pressure in the neck, head or back; weakness,
- lack of coordination or paralysis of part of the body; numbness,
- tingling or loss of feeling in the hands and feet;
- loss of bladder or bowel control;
- difficulty walking or balancing;
- difficulty breathing after the injury; or a twisted neck or back.
- People with these symptoms should seek immediate medical attention.
Causes of Spinal Cord Injury
Spinal cord injury (SCI) can have many causes. The way a person’s injury affects them can be different depending on the cause of SCI. SCI can generally be described as being ‘traumatic’ or due to a trauma, or ‘non-traumatic’ being due to other cause A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in traumatic injury to the spinal cord:
- a violent attack such as a stabbing or a gunshot
- diving into water that’s too shallow and hitting the bottom
- trauma during a car accident (specifically trauma to the face, head and neck region, back, or chest area)
- falling from a significant height
- head or spinal injuries during sporting events
- electrical accidents
- severe twisting of the middle portion of the torso
Non-traumatic spinal cord injury can be caused by a wide range of health problems and diseases. The most common are:
Arthritis and degeneration of the spinal column
- Circulation or bleeding problems
- Effects of Spinal Cord Injury
The effects of spinal cord injury may include the following:
- Loss of movement.
- Loss of sensation.
- Loss of bowel and/or bladder control.
- Exaggerated reflex actions or spasms.
- Changes in sexual function, sexual sensitivity and fertility.
- Pain or intense stinging sensation.
- Diagnosis of Spinal Cord Injury
The diagnosis of spinal cord injury is carried out in two ways
Often, doctors can recognize a spinal cord disorder based on its characteristic pattern of symptoms. Doctors always do a physical examination, which provides clues to the diagnosis and, if the spinal cord is damaged, helps doctors determine where the damage is. An imaging test is done to confirm the diagnosis and determine the cause.
- These Include
- Spine X-rays
- MRI or CT scan of the spine
- Somatosensory evoked potential (SSEP) magnetic or testing stimulation
- Myelogram is the X-ray of the spine after injecting dye
Treatment of Spinal Cord Injury
Unfortunately, there are at present no known ways to reverse damage to the spinal cord. However, researchers are continually working on new treatments, including prostheses and medications, which may promote regeneration of nerve cells or improve the function of the nerves that remain after an SCI.
SCI treatment currently focuses on preventing further injury and empowering people with an SCI to return to an active and productive life.
At the Scene of the Incident
Quick medical attention is critical to minimizing the effects of head, neck, or back trauma. Therefore, treatment for an SCI often begins at the scene of the injury.
Emergency personnel typically:
- Immobilize the spine as gently and quickly as possible using a rigid neck collar and a rigid carrying board
- Use the carrying board to transport the patient to the hospital
- In the Emergency Room
Once the patient is at the hospital, health care providers focus on:
Maintaining the person’s ability to breathe
Immobilizing the neck to prevent further spinal cord damage
Doctors also may treat an acute injury with:
- Doctors may use surgery to remove fluid or tissue that presses on thespinal cord (decompression laminectomy); remove bone fragments, disk fragments, or foreign objects; fuse broken spinal bones; or place spinal braces.1
- This technique stabilizes the spine and brings it into proper alignment.
- Methylprednisolone (Medrol). If this steroid medication is administered within 8 hours of injury, some patients experience improvement. It appears to work by reducing damage to nerve cells and decreasing inflammation near the site of injury.
- Experimental treatments. Scientists are pursuing research on how to halt cell death, control inflammation, and promote the repair or regeneration of nerves.2 See “Is there a cure for SCI?”
Recovery from Spinal Cord Injury
- People with SCI may benefit from rehabilitation, including3,4
- Physical therapy geared toward muscle strengthening, communication, and mobility
- Use of assistive devices such as wheelchairs, walkers, and leg braces
- Use of adaptive devices for communication
- Occupational therapy focused on fine motor skills
- Techniques for self-grooming and bladder and bowel management
- Coping strategies for dealing with spasticity and pain
- Vocational therapy to help people get back to work with the use of assistive devices, if needed
- Recreational therapy such as sports and social activities
- Improved strategies for exercise and healthy diets (obesity and diabetes are potential risk factors for persons with SCI)
- Functional electrical stimulation for assistance with restoration of neuromuscular function, sensory function, or autonomic function (e.g., bladder, bowel, or respiratory function)
Cost of Spinal Cord Injury Treatment
Spinal cord injury treatments in India are very cost-effective as compared to other countries around the world.