Categories: Orthopaedics

Acute Spinal Cord Injury: What Are Your Options?

Though spinal cord injuries are plagued with complications and catastrophic changes, the recent advances in medicine and rehabilitation are filled with hope and promise. Willingness to cooperate with the therapy and having faith in the treatment is vital to a better recovery. If you are recovering from a spinal cord injury, remember to take the support of your loved ones and spend as much time with them as you can. Seek help when you need it, and focus on maximising your abilities. The rest will be taken care of by your treating doctors and professionals.

What is Acute Spinal Cord Injury? 

Injury to the spinal cord or the nerves arising from the base of the spinal canal at the cauda equina due to external trauma such as accidents falls or sport-related injuries qualifies as acute spinal injuries. Damage caused can affect strength, sensation and functionality below the level of injury. In many, spinal cord injury causes permanent disability and damage. The average annual incidence of spinal injury in India is 15,000 and the prevalence is 0.15 million.

What Are the Causes of Acute Spinal Cord Injury?

Common causes for spinal injuries include:

  • Road accidents: Motor vehicle accidents are among the leading causes of spinal injuries.
  • Falls from a height cause vertebral fractures, that lead to compression of the nerves and permanent damage.
  • Violent acts: Gunshot and knife wounds have also been reported as causes for spinal injury, though uncommon.
  • Sport-related injuries: Athletics, diving, and impact sports have contributed to quite a few spinal injury cases in the country every year.
  • Being under the influence: Alcohol plays a role in causing accidents and falls leading to spinal injuries.
  • Other medical causes: Conditions like osteoporosis, cancer and arthritis can lead to acute injury to the spinal cord.

Risk Factors to Cause Acute Spinal Cord Injury

What makes you more susceptible to spinal cord injuries? Here are some risk factors:

  • People in the age group of 16-30 years: People of this age group are more likely to suffer from a traumatic spinal injury.
  • Men are disproportionately more prone to spinal cord injuries, as per statistics.
  • People older than 65 years of age: Older people commonly suffer from falls that can cause damage to the spinal cord.
  • Pre-existing bone or joint disorders: Having medical conditions like osteoporosis or arthritis can make you more susceptible to spinal injuries.
  • Overly adventurous behaviour: Diving in shallow waters, playing sports without adequate protective gear can lead to spinal injury.

What are the Symptoms of Acute Spinal Cord Injury?

Pathophysiology of spinal cord injury. Symptoms after a spinal cord injury depend on the size and severity of the injury. The level of spinal cord injury refers to the point below which there is loss of sensations of motor sensation.

Types of spinal cord injury:

The degree of injury is classified into complete and incomplete:

  • A complete injury occurs when there is a total loss of sensations and motor functions below the level of the spinal cord.
  • Incomplete injury refers to the kind of damage which causes only partial loss of sensations and ability to perform activities below the level of damage.

Complications of spinal cord injury include paralysis. The total loss of movement in both hands and legs, the trunk and pelvic organs is referred to as quadriplegia. Loss of movement and sensations in a part of the trunks, legs and pelvic organs is known as paraplegia.

Here are some of the symptoms experienced after a spinal injury:

  • Inability to move
  • Loss or altered sensation
  • Exaggerated reflexes
  • Loss of bladder and bowel control
  • Intense pain or a stinging sensation
  • Sexual dysfunction
  • Difficulty in breathing or coughing

Diagnosis and Treatment of Acute Spinal Cord Injury

Diagnosis of spinal injuries:

Spinal cord injuries are a medical emergency that requires rapid and complete evaluation. Diagnosis begins with obtaining a full detailed history of any pre-existing condition and how the injury occurred.

Tests include:

  • Imaging tests: X-rays and CT (Computerised Tomography) scans show evidence of bone damage and occlusion of the spinal canal. MRI (Magnetic Resonance Imaging) scans show evidence of soft tissue damage.
  • Blood tests are done to rule out pre-existing conditions and evidence of infections.

Treatment of spinal cord injury

Treatment for spinal cord injuries depends on the age of the patient, their general condition, the severity of the injury and the expected course of the injury.

Currently, there is no method to repair a damaged nerve or spinal cord. Researchers are now showing promising results in facilitating the regeneration of damaged nerves.

Treatment modalities include:

  • Observation and medical management
  • Medications like steroids reduce inflammation and swelling.
  • Devices to aid breathing, such as ventilators
  • Bladder catheterization
  • Feeding tube to fulfil nutritional requirements.
  • Surgery to stabilize fractured bones or to relieve pressure on the nerves.

Rehabilitation of spinal cord injury

Recovery from a spinal cord injury involves long-term hospitalization and rehabilitation. A multidisciplinary team is required to aid recovery, including physiotherapists, nurses, speech therapists, and various specialists to control pain, maintain bowel and bladder function and reduce spasticity.

Can You Fully Recover From Acute Spinal Cord Injury?

The extent of recovery from a spinal cord injury depends on the severity of the injury, the level of damage, and the overall physical condition. Complete recovery occurs very rarely and most people continue to have long-term problems. However, physical therapy and occupational therapy helps to cope with the disabilities and adapt to a new way of life.

Long Term Impact on a Person with Acute Spinal Cord Injury

Trauma leading to spinal cord injury can be a very devastating event for your loved ones and you. The healthcare team will provide guidance on rehabilitation and life post-hospitalization as well as educate your caregivers on the signs and symptoms of an emergency.

It is important to work toward maximizing your abilities and have faith in your treatment. Recovery can happen even one or two years after the injury.  If you are feeling depressed, opt for sessions with a mental health professional who can prescribe antidepressants and psychotherapy.

At NH, the state-of-the-art facilities and multi-disciplinary teams of specialists offer the best in spinal care as well rehabilitation. A holistic approach to the treatment of spinal injuries offers the latest in medical therapies as well as assistive devices for better living.

Dr. Hrutvij Bhatt | Consultant – Orthopaedics | Narayana Multispeciality Hospital, Ahmedabad

Narayana Health

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