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World Spinal Cord Injury Day: Everything you need to know

World Spinal Cord Injury Day: Everything you need to know
The World Health Organization (WHO) and the International Spinal Cord Society (ISCoS) designated September 5 as World Spinal Cord Injury Day to raise general public awareness on the issue, to help people with disabilities live better-integrated lives and increase the chances of successful prevention programmes.
What is a Spinal cord injury?
Spinal cord injury (SCI) is the damage to the spinal cord caused by trauma, disease, or degeneration, tearing it partially or completely while permanently altering the strength, sensation, and other body functions below the site of injury. Millions of nerves run through the spinal cord, carrying messages to and from the brain to all parts of the body. Damage to the spinal cord can result from an injury to the bony vertebral column protecting it- commonly road traffic accident, fall from height, and occupational injury.
Around 2.5 – 5 lakh people (mostly young adults) worldwide are diagnosed with SCI yearly, which also is responsible for premature death in 2 out of 5 such people. For the injured, a spinal cord injury (SCI) that results in paralysis has devastating physical, mental, social, sexual, and vocational consequences.
What are the symptoms to look out for?
Symptoms are determined based on the severity and location of the injury on the spinal cord:
  • Sensory impairment
  • Loss of movement
  • Loss of bladder and bowel control
  • Spasms or exaggerated reflexes
  • Extreme lasting pain
  • Numbness
  • Shock-like sensations
  • Impaired breathing
  • What causes SCI's?
    SCI's can be caused by:
    • Road traffic accidents and falls (leading cause for mortality)
    • Assaults
    • Sports/recreational injuries
    • Electrical/industrial accidents
    • Birth injuries affecting the spinal cord in the neck
    • Tumour, infection, or inflammation compressing the cord
    • Arteriovenous malformations (blood vessel compression) or prolonged drop in blood pressure.
    • How are SCI’s diagnosed?
      In a trauma situation, doctors primarily check for a working airway, proper breathing, and a pulse followed by a neurological assessment that tests muscle strength, sensory function, and body movement.
      The following tests can be used to diagnose a spinal cord injury:
      • Plain x-rays detect vertebral malalignments like fractures and dislocations.
      • Bone fractures, bleeding, abnormal bone growth, and spinal stenosis can be detected using a CT scan.
      • Brain and spinal cord tumors, herniated discs, vascular irregularities, bleeding, and inflammation that may compress the spine and spinal cord, can be detected using an MRI scan.
      • Prevention of spinal injury
        • Wear a seat belt while in the car.
        • Wear a full-face helmet with a belt.
        • Do not handle the neck of injured (especially unconscious person)
        • Use a cervical collar and protective spinal board during transport of injured person.
        • Side rails at home and old age home for elderly to prevent the fall.
        • Use waist belts during occupation especially those who work at heights. Work as much as possible on the ground when feasible.
        • Take precautions when working on a fragile surface.
        • Take precautions from a falling object on the neck or head at construction sites or weak structures
        • Work with scaffolding and nets in heights.
        • Not to rest the ladder on weak or slippery surfaces.
        • If a person does not have experience for a job to work at heights, better not allow him to work at heights.
        • What are the available treatment options?
          Unfortunately, SCI’s cannot be reversed. We should help patients to reach the hospital as soon as possible over a spinal board to be assessed by a neurosurgeon or spine surgeon. However, rehabilitation and adaptive devices can assist a person in gaining more independence and improving their quality of life. Some helpful treatment options include:
          For SCI’s, surgery is the most common first treatment needed. Surgical removal of bone fragments, foreign objects, herniated discs, or fractured vertebrae that appear to be compressing the spinal cord or nerves is frequently required to avoid future pain or deformity and to stabilise the spine with metal instrumentation.
          Occupational therapy, physical therapy, and rehabilitation help people improve and maintain their long-term quality of life. Some people might require regular physiotherapy sessions to maintain their physical strength and mobility. Backcare is needed to prevent the bedsores and limb movements to prevent the blood clot in limbs (DVT- deep vein thrombosis)
          Counselling and psychotherapy may be beneficial in dealing with emotional trauma following an SCI. Reaching out to friends and family for support and day-to-day assistance will also help in the easy recovery.
          Traction may be required to stabilise and align the spine. A rigid neck collar or a special bed may be effective in immobilising the body.
          Experimental treatments to prevent neuronal cell death, reduce inflammation, and promote nerve regeneration are being studied and discovered. For instance, hypothermia might be induced for 24-48 hours to help prevent damaging inflammation. Stem cell therapy is in the early stage, holds promise for spinal cord injury but the true benefit is not clearly shown yet- needs further assessment and basic experiment.
          The article is authored by Dr Ganesh Veerabhadraiah, Consultant - Brain & Spine - Neuroendovascular Surgery, Fortis Hospitals, Cunningham Road. Views expressed are personal.