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.
4.
5. The spinal cord is very sensitive to injury. Unlike
other parts of your body, the spinal cord does not
have the ability to repair itself if it is damaged.
6. 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
7. 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.
8. 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.
9. Causes and risk factors
Spinal cord trauma can be caused by a number of
injuries 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 spine
is weakened (such as from rheumatoid
arthritis or osteoporosis) or if the spinal canal
protecting the spinal cord has become too narrow
(spinal stenosis) due to the normal aging process.
10. Spinal cord injuries are described as either
complete or incomplete.
In acomplete spinal cord injury there is
complete loss of sensation and muscle function in
the body below the level of the injury.
In an incomplete spinal cord injury there is
some remaining function below the level of the
injury. In most cases both sides of the body are
affected equally.
11. 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 .
12.
13.
14. CERVICAL (NECK) INJURIES
When spinal cord injuries occur in the neck
area, symptoms can affect the arms, legs, and middle
of the body. The symptoms may occur on one or both
sides of the body. Symptoms can also include
breathing difficulties from paralysis of the breathing
muscles, if the injury is high up in the neck.
THORACIC (CHEST LEVEL) INJURIES
When spinal injuries occur at chest level, symptoms
can affect the legs. Injuries to the cervical or high
thoracic spinal cord may also result in blood pressure
problems, abnormal sweating, and trouble
maintaining normal body temperature.
15. LUMBAR SACRAL (LOWER BACK) INJURIES
When spinal injuries occur at the lower back
level, symptoms can affect one or both legs, as
well as the muscles that control the bowels and
bladder.
16. 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
17. Signs and tests
Spinal cord injury is a medical emergency that
needs immediate medical attention.
The health care provider will perform a physical
exam, 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 injecting
dye)
Spine x-rays
18. Treatment
A spinal cord injury is a medical emergency that
needs to be treated right away. The time between
the injury and treatment can affect the outcome.
Corticosteroids, such as dexamethasone , are
used to reduce swelling that may damage the
spinal cord.
If spinal cord pressure is caused by a growth that
can be removed or reduced before spinal nerves
are completely destroyed,paralysis may improve.
Ideally,
corticosteroids should begin as soon as possible
after the injury.
19. Bed rest may be needed to allow the bones of the
spine to heal.
Spinal traction may be recommended. This can
help keep the spine from moving.
20. The health care team will also provide information
on muscle spasms, care of the skin, and bowel and
bladder dysfunction. skin will be protected against
pressure sores.
You will probably need physical therapy, occupational
therapy, and other rehabilitation therapies after the
injury has healed. Rehabilitation will help cope with
the disability from spinal cord injury.
Muscle spasticity can be relieved with medications
taken by mouth or injected into the spinal canal. Botox
injections into the muscles may also be helpful.
Painkillers (analgesics), muscle relaxers, and
physical therapy are used to help control pain.
21. Surgery may be needed to:
Remove fluid or tissue that presses on the spinal
cord (decompression laminectomy)
Remove bone fragments, disk fragments, or
foreign objects
Fuse broken spinal bones or place spinal braces.
22. Complications
These complications include:
urinary tract infections or urinary
incontinence (inability to control the flow of urine),
bowel incontinence (inability to control bowel
movements),
pressure sores,
infections in the lungs (pneumonia),
blood clots,
muscle spasms,
chronic pain, and
depression.
