Spine and spinal cord injury

permanent disability or loss of motor ability (paralysis) and sensation below the injury site. Paralysis that affects most of the body, including the arms and legs, is called quadroplegia or tetraplegia . When the spinal cord is affected only in the lower part of the body, the condition is called paraplegia .

Symptoms

In a partial spinal cord injury, also called a partial injury, the spinal cord can send some messages to and from the brain. Therefore, patients with partial spinal cord injury have some sensitivity and probably some motor function below the affected area.

Complete damage to the spinal cord is accompanied by a complete or almost complete loss of motor function and sensitivity below the affected area. However, even with a complete injury, the spinal cord is almost never completely cut. Doctors use the term “complete” to describe a large area of ​​damage to the spinal cord. This is an important difference because many patients with partial spinal cord injuries can recover, while those with complete injuries cannot.

Spinal cord injuries of any kind can result in one or more of the following signs and symptoms:

  • pain or intense burning caused by damage to nerve fibers in the spinal cord;
  • loss of ability to move;
  • loss of sensation, including the ability to feel heat, cold, and touch;
  • loss of control over the work of the intestines and bladder;
  • excessive reflex activity or spasms;
  • changes in sexual function, sexual sensitivity and reproductive function;
  • difficulty breathing, coughing or expectoration of a secret from the lungs.

 

The reasons

The spinal cord and brain together make up the central nervous system, which controls most of the body’s functions. The spinal cord is approximately 38-43 cm long and is made up of long nerve fibers that carry information to and from the brain.

These nerve fibers enter the nerve roots that protrude between the vertebrae – 33 bones that surround the spinal cord and make up the spine. It is there that the nerve fibers break down into peripheral nerves that travel to other parts of the body.

The lesion can be traumatic and non-traumatic:

  • Traumatic spinal cord injury may result from a sudden, traumatic blow to the spine that breaks, displaces, destroys, or compresses one or more vertebrae. Such a lesion may also result from a gunshot or stab wound to the spinal cord. Additional damage traditionally manifests itself after a few days or weeks due to bleeding, swelling, inflammation, and fluid accumulation in and within the spinal cord.
  • Non-traumatic spinal cord injury can be caused by arthritis, cancer, blood vessel problems or bleeding, inflammation or infections, or degenerative disease of the spine.

Whether the injury is traumatic or non-traumatic, the lesion affects the nerve fibers that pass through the affected area and may impair some or all of the relevant muscles and nerves below the lesion. Spinal injuries appear most often in the neck (cervical) and lower back (thoracic and lumbar). Thoracic and lumbar injuries can cause leg problems, affect bowel and bladder control, and affect sexual function. Injury to the cervical spine can affect breathing, as well as movement of the upper and lower extremities.

The spinal cord ends at the lower border of the first lumbar vertebra. Lesions below this vertebra do not involve the spinal cord. However, an injury to this part of the back or pelvis can damage the nerve roots in this area and cause loss of leg function, problems with bowel and bladder control, and sexual dysfunction.

Examination and diagnosis

Prior to diagnosis, ambulance workers are trained in the care of victims of traumatic head, neck and trunk injuries, taking into account the likely damage to the spinal cord or spinal instability. An important action during the initial stage of treatment is the immobilization of the spine.

Prevention of further damage

Spinal immobilization can prevent damage to the spine or worsening of an already existing injury. For this reason, ambulance personnel are trained on how to treat an injured person without moving their neck and back. Paramedics use hard collars worn around the affected neck, lay the victim on a hard board until a full examination is made.

In the emergency department, the doctor can rule out spinal cord injury by carefully examining the sick person, checking their sensory and motor functions, and asking questions about the accident. But if the victim complains of pain in the neck, is unconscious, or has clear signs of limb weakness or other neurological lesions, emergency examinations will need to be performed to make a diagnosis.

These surveys include:

  • Radiography
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Myelography

But the diagnosis doesn’t stop there. A few days after the injury, the doctor will perform a neurological examination to determine the severity of the injury and the likely length of recovery. Additional x-rays, MRIs, or other examinations may be required.

Treatment

Fifty years ago, spinal cord injury was traditionally fatal. At the time, most injuries were severe. With complete spinal cord injury, there was little chance of treatment.

Today, there is still no way to reverse the progression of spinal cord lesions. But modern injuries are traditionally less significant, they are partial injuries of the spinal cord. And the advances of the past years have brought favorable changes to the recovery regimen for victims of spinal cord injury and have significantly reduced the amount of time that survivors have to spend in the hospital. Researchers are developing new therapies, including innovative therapies, prosthetics, and drug products, that promote nerve cell regeneration or improve the function of remaining nerves after spinal cord injury.

In the meantime, the treatment of spinal cord injury is focused on preventing other injuries and giving patients with spinal cord injury the chance to return to an active and productive life within the limits of their disability. All this requires urgent medical attention and constant care.

According to the site www.neurosurgery.com.ua

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