- 1. SPINAL CORD INJURY Dr. Jayesh Patidar PhD.,M.Sc. Nursing
2. What is the spinal cord?The spinal cord is a collection of nerves that travels from the bottom of the brain down your back. There are 31 pairs of nerves that leave the spinal cord and go to arms, legs, chest and abdomen. These nerves allow your brain to give commands to your muscles and cause movements of your arms and legs. 3. The spinal cord is very sensitive to injury. Unlikeother parts of your body, the spinal cord does nothave the ability to repair itself if it is damaged. 4. DEFINITION A spinal cord injury occurs when there is damage to the spinal cord either from trauma, loss of its normal blood supply, or compression from tumor or infection 5. Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the surrounding bones, tissues, or blood vessels. 6. Incidence There are approximately 10,000 new cases of spinal cord injury each year in the United States. They are most common in white males. Specifically, 80% of spinal cord injuries occur in males, and 2/3 occur in whites. Most injuries occur in patients 16-30 years of age. 7. Causes and risk factors Spinal cord trauma can be caused by a number ofinjuries to the spine, including: Assault Falls Gunshot wounds Industrial accidents Motor vehicle accidents Sports injuries (particularly diving into shallow water) A minor injury can cause spinal cord injury if the spineis weakened (such as from rheumatoidarthritis or osteoporosis) or if the spinal canalprotecting the spinal cord has become too narrow(spinal stenosis) due to the normal aging process. 8. Spinal cord injuries are described as eithercomplete or incomplete. In acomplete spinal cord injury there iscomplete loss of sensation and muscle function inthe body below the level of the injury. In an incomplete spinal cord injury there issome remaining function below the level of theinjury. In most cases both sides of the body areaffected equally. 9. An injury to the upper portion of the spinal cord in the neck can cause quadriplegia-paralysis of both arms and both legs. If the injury to the spinal cord occurs lower in the back it can cause paraplegia-paralysis of both legs . 10. CERVICAL (NECK) INJURIES When spinal cord injuries occur in the neckarea, symptoms can affect the arms, legs, and middleof the body. The symptoms may occur on one or bothsides of the body. Symptoms can also includebreathing difficulties from paralysis of the breathingmuscles, if the injury is high up in the neck.THORACIC (CHEST LEVEL) INJURIES When spinal injuries occur at chest level, symptomscan affect the legs. Injuries to the cervical or highthoracic spinal cord may also result in blood pressureproblems, abnormal sweating, and troublemaintaining normal body temperature. 11. LUMBAR SACRAL (LOWER BACK) INJURIES When spinal injuries occur at the lower backlevel, symptoms can affect one or both legs, aswell as the muscles that control the bowels andbladder. 12. Symptoms Injuries at any level can cause: Increased muscle tone (spasticity) Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms) Numbness Sensory changes Pain Weakness, paralysis 13. Signs and tests Spinal cord injury is a medical emergency thatneeds immediate medical attention. The health care provider will perform a physicalexam, including a brain and nervous system(neurological) exam..The following tests may be ordered: CT scan or MRI of the spine Myelogram (an x-ray of the spine after injectingdye) Spine x-rays 14. Treatment A spinal cord injury is a medical emergency thatneeds to be treated right away. The time betweenthe injury and treatment can affect the outcome. Corticosteroids, such as dexamethasone , areused to reduce swelling that may damage thespinal cord. If spinal cord pressure is caused by a growth thatcan be removed or reduced before spinal nervesare completely destroyed,paralysis may improve.Ideally, corticosteroids should begin as soon as possibleafter the injury. 15. Bed rest may be needed to allow the bones of thespine to heal. Spinal traction may be recommended. This canhelp keep the spine from moving. 16. The health care team will also provide informationon muscle spasms, care of the skin, and bowel andbladder dysfunction. skin will be protected againstpressure sores. You will probably need physical therapy, occupationaltherapy, and other rehabilitation therapies after theinjury has healed. Rehabilitation will help cope withthe disability from spinal cord injury. Muscle spasticity can be relieved with medicationstaken by mouth or injected into the spinal canal. Botoxinjections into the muscles may also be helpful. Painkillers (analgesics), muscle relaxers, andphysical therapy are used to help control pain. 17. Surgery may be needed to: Remove fluid or tissue that presses on the spinalcord (decompression laminectomy) Remove bone fragments, disk fragments, orforeign objects Fuse broken spinal bones or place spinal braces. 18. Complications These complications include: urinary tract infections or urinaryincontinence (inability to control the flow of urine), bowel incontinence (inability to control bowelmovements), pressure sores, infections in the lungs (pneumonia), blood clots, muscle spasms, chronic pain, and depression. 19. THANK YOU
