spinal cord injury treatment guidelines

A traumatic spinal cord injury(SCI) is damage to any part of the spinal cord or nerves at the end of the spine.

Trauma to the spinal cord may happen because of an unexpected blow or cut to the back.
An SCI frequently causes permanent loss of strength, sensation, and function below the site of the wound.  Rehabilitation and assistive devices help patients with spinal cord injuries to lead productive, independent lives.

How To Identify A Spinal Cord Trauma?

Assume that the patient has a traumatic spinal cord injury if he/she shows the following symptoms:
● There are signs of a head injury
● There is a change in the person’s level of awareness
● The patient complains of acute pain in his or her neck or back
● There has been a forceful impact on the back or head.
● The person experiences weakness, numbness, or paralysis of his or her legs, bladder, or bowels

How to Give First Aid for Spinal Injury

Trauma management begins before reaching the hospital. If you suspect a person to have an injured neck or back, do not move or roll him or her.

If you move the affected person, permanent paralysis and other serious complications may happen. Provide the following first-aid whichever is possible without moving the person& head or neck:
1. Keep the person still.
2. Place rolled towels or cloth on either side of the neck.
3. If the person shows no signs of circulation breathing or movement, begin CPR, but do not bend the head back to open the airway.
4. If the person does not have a pulse, start chest compression.
5. If he is wearing a helmet, leave it on.
6. If the person is vomiting, roll him on the side with another helper who holds his spine straight
7. Get medical help. Call an Ambulance

Preliminary Tests & Diagnosis

When you reach the hospital, your doctor will carefully inspect, examine and diagnose the patient to rule out spinal cord injury.

He will test all limbs and senses for movement, function and also by talking to the patient.

However, if the person has neck pain, is subconscious, has symptoms of weakness or nerve injury, emergency diagnostic tests may be required. At Eva hospital for Orthopedics, the common tests that doctors prescribe are:

1. X-rays. According to dr Tanveer Bhutani, an x-ray is the first test we do for suspected spinal trauma. X-
rays can show vertebral problems, tumors, fractures, or degenerative vicissitudes in the spine.

2. CT Scan or computerized tomography. A CT scan may provide more detailed aspects of the abnormalities were seen in the X-ray.

It provides a cross-sectional view that outlines bone, disk, and other problems. MRI or Magnetic resonance imaging. MRI produces computer-generated images. It is very useful in identifying herniated disks, blood clots, or other tissues that may be compressing the spine.

After a few days when the swelling has reduced, Dr. Bhutani conducts a detailed clinical examination to conclude the level and totality of your condition.

It mainly involves testing muscle strength and the ability to sense light touch and pinprick sensations.

Treatment

Traumatic SCI treatment mainly involves immobilization, assessment & imaging.
Nearly 1/4th of injuries worsen during the extraction, transport, or handling of the patient. spinal immobilization is a priority. The comprehensive treatment consists of:-

Surgical Treatment

“Sometimes, we may have to take a patient immediately to the operation theatre,” says Dr. Bhutani. This is done for patients who have incomplete SCI or with progressive neurological deterioration.

Even when the damage to the spinal cord cannot be reversed by surgery, it is required to stabilize the injury and prevent further damage. The course is decided after tests.

Non-surgical Management

To operate or not to operate is relative. A patient’s health, saving a limb and medical history are the main considerations.

Non-surgical treatment has less benefit in proven cases of neurological deficit but may be beneficial for a stable spine.

Extended immobility, however, can increase the risk of bedsores, deep vein thrombosis pneumonia.

Rehabilitation

The rehabilitation team primarily includes a physical therapist, a psychologist, and a dietitian.

The patient is educated on the consequences and further prevention of spinal cord injury. You are counseled about rebuilding and enhancing your quality of life.

Also Read: Physical Therapy and Exercises After Knee Replacement Surgery

Conclusion

Managing patients suffering from acute spinal cord injury can be challenging. The immediate handling and immobilization of patients right after injury are crucial for safety from severity.

The main role of surgery is to prevent further neurological depreciation through decompression whilst stabilization lessens the complications related to immobility and speeds up a rehabilitation.