The spinal cord connects the brain and the body. Spinal cord injury occurs when there is damage to the spinal cord either due to trauma or due to degenerative diseases. Spinal cord injury is a serious condition because of the inability of the spinal cord to repair itself. Almost all cases of spinal cord injury require medical intervention.
The seriousness of this condition is implied from the fact that the severity of disability with skull fracture is estimated at 43%, while it is a staggering 72% with spinal cord injuries. It poses a devastating effect on physical, mental, emotional health and affects the socioeconomic status of the patient. According to the WHO data, the risk of mortality is high in the first year of spinal cord injury. People with the condition versus those without spinal cord injury, are 2 to 5 times more likely to have a premature death.
The symptoms due to spinal cord injury vary with the site of injury and its severity. The severity of the injury depends upon the level of the spinal cord affected. The higher the level of spinal cord injury, the more is the risk of neurological dysfunction.
The patient may experience the following symptoms:
Loss of movement in arms, hands, legs, or other organs
Loss of bladder and bowel control
Numbness or tingling sensation in the fingers and toes
Difficulty walking and maintaining coordination
Loss of sensation
Loss of normal sexual function
Pain due to damaged nerve fibres
The causes of spinal cord injury are divided into traumatic injuries and non-traumatic injuries.
Traumatic injuries: Traumatic injuries like falls from a significant height, motor accidents, injuries during the contact sports, for example, football, diving into the shallow water, and hit bottom, electrical accidents, violence, for example, gunshot or knife injuries, and gymnastics.
Non-traumatic injuries: Injury to the spinal cord may also be due to non-traumatic injuries. These include cancer, multiple sclerosis, inflammation, arthritis, and osteoporosis.
Injury to the spinal cord can happen anytime to anyone, however certain factors increase the risk of injury. These factors are:
Male are at increased risk of traumatic spinal cord injuries as compared to females.
People within the age range of 16 years to 30 years are at increased risk due to risky behavior.
The Elderly (above 65 years) are at risk due to falls.
People with osteoporosis and arthritis
Spinal cord injury may result in several complications like:
Respiratory dysfunction such as weakness of respiratory muscles and ineffective cough, pneumonia, and respiratory failure.
Cardiovascular complications such as orthostatic hypotension, swelling in extremities, increased risk of clotting, and pulmonary embolism.
Urinary and bowel complications such as bladder dysfunction, increase risk of urinary tract infection, and poor bowel control.
Spasticity is characterized by painful muscle spasms, poor tone in soft muscles, and hyperreflexia.
Pain syndrome including musculoskeletal pain and neuropathic pain.
Pressure sores may progress to cause infection and septicemia.
Sexual health alterations such as erection and ejaculation changes in male and lubrication changes in females.
Weight loss, reduced mobility, and muscle dystrophy
Psychological impacts like depression, anxiety, and anger.
Measures for preventing spinal cord injury are:
Do not drink and drive. Use a seat belt while driving.
Ensure that all safety gears are in place while playing contact sports.
Adequate precautionary measures should be taken to prevent falls like the use of handrails, using non-slip slippers and floor mats, and using a dry bathroom dry to avoid falls.
Always ensure you are not diving into shallow water.
Diagnosis of the spinal cord injury may be done through one or more of the following methods:
Comprehensive physical inspection including sensing function and ability to move the extremities
Radiological evaluation techniques like X-ray, CT scan and MRI may help to determine the presence of blood clots, fractures, degenerative changes, herniated discs, or other abnormalities.
As there is no treatment available to reverse the damage done in the spinal cord due to injury, the primary aim of the treatment is to prevent complications and make the patient as independent as possible. Following are some of the treatment options:
Medications for pain management
Immobilization to prevent further complications
Surgery to remove the objects or masses that are compressing the spine
Rehabilitation plays a vital role in the early stage of recovery. The rehabilitation team comprising the physiotherapists, occupational therapists, dietitians, nurses, and recreational therapists are committed to improving the quality of life. Due to spinal cord injury, the patient may experience paralysis. Without rehabilitation, as historically evident, the patient also has serious repercussions like immobilization, isolation, and mortality.
HOD And Consultant - Spine Surgery
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