March 02, 2022

Spinal cord injury explained

Spinal Cord Injury (SCI):-

A spinal cord injury is a damage caused to any part of the spinal cord or nerves at the end of the spinal canal which results in permanent changes in strength, sensation, and other body functions below the point of the injury. Unlike other parts of our body, the spinal cord does not have the ability to repair itself if it is damaged. 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.

Causes of Spinal Cord Injury (SCI):-

Traumatic injury -

Motor vehicle accidents, shallow diving, acts of violence, sports injuries, electric shock, loss of oxygen related to surgical complications, or underwater accidents.

Non-traumatic injury -

Tumors, arthritis, cancer, inflammation, infections, or disk degeneration of the spine.

Damage to the spinal cord by these types of injuries results in dislocation, compression, hyperextension, hyperflexion, and burst fracture. The spinal cord doesn’t have to be cut in order to have a loss of function.

Symptoms of a spinal cord injury:-

Spinal cord injury symptoms depend on the type whether complete or incomplete in nature & location of the damage. Immediate medical attention is required if you notice any of the following issues after an injury:-

· Weakness in the arms and or legs.

· Decreased sensation in the arms and or legs.

· Loss of bladder or bowel control.

· Severe pain or pressure in the neck or back.

· Unusual lumps along the spine.

· Difficulty breathing.

Levels of Spinal cord injury:-

There are four sections of the spinal cord that impact the level of spinal cord injury: cervical, thoracic, lumbar, and sacral. Each section of the spine protects different groups of nerves that control the body. The types and severity of spinal cord injuries can depend on the section of the spine that is injured.

Cervical Spinal Cord injury- C1-C8:

Cervical spinal cord injuries affect the head and neck region above the shoulders. It is the most severe level of spinal cord injury. This region of the spinal cord controls our head, neck, arms, legs, and diaphragm. Cervical spinal cord injuries result in paralysis or weakness in the arms and legs which results in quadriplegia. Cervical injuries are accompanied by loss of sensation, bowel and bladder function, regulating body temperature, and sexual dysfunction.

Thoracic Spinal Cord Injury-T1-T12:

Thoracic spinal cord injuries affect the upper chest, mid-back, and abdominal muscles. Thoracic spinal cord injuries are not as common due to the protection it receives from the rib cage. These types of injuries cause paralysis or weakness in the legs along with loss of physical sensation, bowel, bladder, and sexual dysfunction. Arm and hand function is usually normal with this level of spinal cord injury. To help produce stability for the trunk patients usually wear braces around the abdomen.

Lumbar Spinal Cord Injury- L1-L5:

Lumbar spinal cord injuries affect the hips and legs. Lumbar spinal cord injuries only affect the lower extremities which also is referred to as paraplegia. Physical sensation, bowel, bladder, and sexual dysfunction can also be lost during these types of injuries. Lumbar injuries usually require surgery and external stabilization. The lumbar region of the spinal cord controls signals to the back, abdomen, and buttocks, along with some aspects of the external genital organs. Individuals may need a wheelchair or walk with braces with this level of spinal cord injury.

Sacral Spinal Cord Injury- S1-S5:

Sacral spinal cord injuries affect the hips, back of the thighs, buttocks, and pelvic organs. Sacral Spinal Cord injuries cause loss of bowel, bladder, and sexual dysfunction. They can cause weakness and/or paralysis in the hips and legs. The sacral region of the spine controls signals to the thighs, lower parts of legs, feet, and genital organs. Individuals are most likely able to walk with this level of spinal cord injury.

Types of spinal cord injuries:-

Complete Injury:-

Happens when the spinal cord is compressed or severed completely which affects the ability of the brain to communicate motor and sensory functions to the body below the level of injury. Symptoms of a complete spinal cord injury could be loss of sensation below the level of injury, complete loss of function below the level of injury, unable to control bowel or bladder, and depending on how high the level of injury is a person could have difficulty breathing also.

Incomplete Injury: -

Happens when the spinal cord is compressed or injured but the brain still has the ability to send signals below the site of injury. The effects of this type of injury vary. Symptoms of an incomplete spinal cord injury could be retaining some sensation below the site of injury that comes and goes, being able to move some muscles below the level of injury, or pain having chronic pain below the level of injury. For example, a patient recovering from a spinal cord injury from an infection may regain a large about of function back. Spinal cord injuries are unpredictable and vary from person to person depending on the level and type. Throughout the process of recovering from a spinal cord injury, it is vital to remember that each patient still can fulfill their dream of living life to the fullest as a normal person.

Complications arising after spinal cord injury:-

At first, changes in the way your body functions can be overwhelming after the injury. Areas often affected include:-

Bladder control: -

Our brain might not control our bladder because the message carrier i.e. the spinal cord has been injured. However, our bladder will continue to store urine from our kidneys. This increases the risk of urinary tract infections (UTI). The changes may also cause kidney infections and kidney or bladder stones. Clean intermittent catheterization (CIC) is recommended option for SCI patients.

Bowel Control: -

Damage can occur to the nerves that allow a person to control bowel movements. If the spinal cord injury is above the T-12 level, the ability to feel when the rectum is full may be lost. The anal sphincter muscle remains tight, however, the bowel movements will occur on a reflex basis. Although our stomach and intestines work much like they did before your injury. A high-fiber diet with a high liquid intake helps regulate our bowels.

Pressure sores: -

A pressure sore (also called pressure ulcer, bedsore, or skin breakdown) is an area of the skin (muscle, bone) that is damaged due to loss of blood flow below the neurological level of injury, we might have lost some or all skin sensations. Therefore, our skin can't send a message to our brain when it's injured by certain things such as prolonged pressure. This can make us more susceptible to pressure sores, but changing positions frequently help prevent these sores.

Blood Circulatory control: -

A spinal cord injury can cause blood circulatory problems ranging from low blood pressure to swelling of our extremities. These circulation changes can also increase our risk of developing blood clots, such as deep vein thrombosis (DVT) or a pulmonary embolus. Another problem with circulatory control is a potentially life-threatening rise in blood pressure.

Respiratory system: -

Our injury might make it more difficult to breathe and cough if our abdominal and chest muscles are affected. The muscles needed for breathing and coughing may become weak after an SCI. Coughing is needed to clear the lungs of secretions and bacteria. If a person has a weak cough or cannot clear secretions from their lungs, they will be at higher risk for an infection, such as pneumonia.

The neurological level of injury determines what kind of breathing problems one can have. If you have a cervical and thoracic spinal cord injury, you might have an increased risk of pneumonia or other lung problems. Medications and therapy can help prevent and treat these problems.

Bone density: -

After spinal cord injury, there's an increased risk of osteoporosis and fractures below the level of injury.

Fitness and wellness: -

Weight loss and muscle atrophy are common soon after a spinal cord injury. Limited mobility can lead to a more sedentary lifestyle, placing you at risk of obesity, cardiovascular disease, and diabetes.

Sexual health: -

Men might notice changes in erection and ejaculation; women might notice changes in lubrication after a spinal cord injury. Physicians specializing in urology or fertility can offer options for sexual functioning and fertility.

Pain: -

Nerve pain can occur after a spinal cord injury, especially in someone with an incomplete injury.

Spinal Cord Injury Rehabilitation:-

Rehabilitation is the discipline of medicine that guides the physical, psychological, and social recovery of individuals who have become partially or totally disabled because of spinal disease or injury. Rehabilitation helps a person to perform activities of daily living (i.e. cooking, getting dressed, showering, bathing, toileting, mobilizing oneself, etc.

At rehabilitation centers, intense therapy helps to teach ways to increase your daily function whether that's through exercises, compensatory techniques, or assistive technology. In many cases, occupational therapy, physical therapy, and rehabilitation play an essential role in improving and maintaining the long-term quality of life. For some people, this will involve ongoing therapy sessions to maintain physical strength and mobility.

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