Spinal cord injury

Diagnosis

• Physical examination: A healthcare provider will assess and check if the breathing or heart rate are not affected by the spinal cord injury during emergencies. Healthcare providers will evaluate how well the motor and sensory function works.
  Emergency diagnostic procedures may be required if the injured person complains of neck pain, partially alert, or exhibits clear signs of neurological injury or weakness.
• Imaging test:
  • X-rays: Vertebral (spinal column) issues, tumors, fractures, or degenerative changes in the spine can all be seen on X-rays.
  • CT scan: When abnormalities are detected on an X-ray, a CT scan can produce a clearer image. A sequence of cross-sectional images created by computers during this scan can be used to identify bone, disk, and other issues.
  • MRI: A powerful magnetic field and radio waves are used in MRI to create computer-generated pictures. This examination of the spinal cord is beneficial for locating herniated disks, blood clots, and other masses that could compress the spinal cord.
• Electromyelogram: If there is concurrent peripheral nerve injury, a medical professional may also use an electromyogram (EMG) to assess electrical activity in muscles and nerve cells. However, EMG is typically not required in spinal cord injuries.

In order to determine the extent of the injury, a healthcare provider will typically conduct a comprehensive neurological examination a few days following the accident, after allowing time for any swelling to subside. This examination will involve assessing the level and completeness of the injury by testing the patient’s muscle strength, as well as their ability to sense light touch and pinprick sensations.

Treatment

In cases where there is trauma to other parts of the body, emergency surgery may be necessary to address a spinal cord injury. Surgical intervention can also be an option for spinal cord injuries resulting from blood clots, tissue damage, or fractured bones.

The spinal cord damage can’t be repaired, which is unfortunate. Treatment for spinal cord injuries long-term objectives is to improve the quality of life, independence, reducing chronic health conditions, and partially restoring the nerve function.

Ongoing research on new treatments, such as drugs and prosthetics, is leading to improvements in the functionality of the nerves that remain after a spinal cord injury.

• Emergency actions: In order to lessen the impact of head or neck trauma, immediate medical intervention is essential. As a result, spinal cord injury therapy frequently starts at the scene of the accident.
  When transporting a patient to the hospital, emergency professionals usually immobilize the spine as gently and rapidly as they can using a rigid neck collar and a rigid carrying board.
• Early stages of treatment: In the emergency room, healthcare providers prioritize maintaining the patient’s breathing, preventing shock, immobilizing the spinal cord to prevent further injury, and mitigating potential complications such as stool or urinary retention, respiratory or cardiovascular problems, and the formation of blood clots in the limbs.

An intensive care unit admission is typically required for treatment of spinal cord injuries. Patients may be moved to a local spine injury center with a team of specialists in spinal cord medicine, neurosurgery, orthopedic surgery, psychology, nursing, therapists, and social work who are also experienced in treating spinal cord injury.

• • Medications: In the past, methylprednisolone, administered intravenously (IV), has been used to treat acute spinal cord injuries. However, recent studies have indicated that the risks of using this medicine, which include blood clots and pneumonia, exceed the advantages. Methylprednisolone is no longer advised for regular use following a spinal cord injury.
  • Immobilization: The patient could require traction to align or stabilize their spine. Choices include a variety of braces and soft neck collars.
  • Surgery: In order to remove bone fragments, foreign objects, herniated disks, or broken vertebrae that appear to be crushing the spine, surgery is frequently required. In order to stabilize the spine and stop future pain or deformity, surgery may also be required.
  • Experimental treatments: Researchers are looking for ways to reduce inflammation, inhibit cell death, and encourage the regeneration of nerves. For instance, the inflammation may be avoided by reducing body temperature (also known as hypothermia) for 24 to 48 hours.
• Ongoing care: Following the stabilization of the initial injury or condition, medical professionals focus on minimizing potential complications such deconditioning, muscle contractures, pressure ulcers, bowel and bladder problems, respiratory infections, and blood clots.
• Rehabilitation: During the patient’s recovery phase, a team of rehabilitation specialists will begin working with them. This team may include physical therapists, occupational therapists, rehabilitation nurses, rehabilitation psychologists, social workers, dietitians, recreation therapists, and medical professionals who specialize in spinal cord injuries or physical medicine.

Therapy professionals frequently place a strong emphasis on preserving and increasing muscle function, regaining fine motor abilities, and learning how to adapt to do daily chores during the early phases of recovery.

During the rehabilitation process, the patient will acquire and rehearse various new skills, and use tools and technologies that will empower them to live with maximum independence. The patient will be encouraged to resume their favorite hobbies, participate in group and fitness activities, and return to work or school. They will receive support in rebuilding their quality of life and self-sufficiency.

• Medications: Some of the side effects of spinal cord injury may be managed with medication. They include drugs that reduce pain and muscular stiffness as well as drugs that can enhance bowel, bladder, and sexual function.
• New technologies: Innovative medical equipment can increase the independence and mobility of those who have suffered spinal cord injuries. They consist of the following:
  • Computer adaptations: Computer use can be challenging for someone with poor hand function. Key guarding and voice recognition are two examples of the simple to complicated computer adaptations.
  • Modern wheelchairs: Spinal cord injury patients are becoming more mobile and comfortable thanks to improved, lighter wheelchairs. A powered wheelchair is required by some users. Some wheelchairs can even transport their users up and down stairs, over uneven terrain, and up to heights without assistance.
  • Electronic aids: Practically any electrical equipment can be managed by an electronic assistance to daily living. Switches, voice-activated remote controls, and computer-based remotes can be used to turn devices on and off.
  • Electrical stimulation devices: These complex devices, also known as functional electrical stimulation systems, regulate the arm and leg muscles of persons with spinal cord injuries so they may stand, walk, reach, and grasp objects.
• Prognosis and recovery: The patient’s prognosis might not be available right away from the healthcare provider. If recovery takes place, it typically depends on how serious and extensive the injury was. Although the first six months are frequently when recovery happens most quickly, some patients continue to improve slowly for up to one to two years.