Spinal trauma: symptoms, treatment, rehabilitation, consequences
Spinal cord injury is a condition that is life-threatening and the victim requires emergency medical care. This pathology is called traumatic disease of the spinal cord (TBSM).
The back of the brain, being a part of the nervous system, is the main coordinator of all organs and muscles. Through it the brain receives signals from the entire body.
Each segment of the spinal cord is responsible for a particular organ, from which he receives reflexes and transmits them. This is determined by the severity of this pathology. These injuries have high mortality and disability.
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Causes and symptoms
The reasons for having a spinal pathology can be grouped into 3 groups. The first group includes the defects that can be either acquired or congenital. They are associated with the violation of the structure of this body. The second group includes various diseases of the spinal cord, resulting from infection, genetic predisposition or occurrence of a tumor.
The third group includes various kinds of injuries that can be self-contained and is combined with a fracture of the spine. This group of reasons includes:
- Car accident;
- Home injury.
The clinical manifestations of the pathology are determined by the severity of the injury. So, outstanding full and partial damage to the spinal cord. With the full lose all nerve impulses are blocked and the victim has no opportunity to recover its locomotor activity and sensitivity. Partial lesion suggests the possibility of only part of nerve impulses and thus maintain some physical activity and have a chance to restore it completely.
Signs of spinal cord injury the following:
- Impaired motor activity;
- Pain accompanied by a burning sensation;
- Loss of sensation when touching;
- No sense of heat or cold;
- Difficulty breathing;
- Active cough without a sense of relief;
- Pain in the chest and heart;
- Spontaneous urination or defecation.
In addition, experts identify the symptoms of spinal cord injury as loss of consciousness, an unnatural position of your back or neck pain that may be dull or sharp and felt around the spine.
Typology of injuries
Spinal cord injuries are classified according to the type and extent of destruction.
- See also: how dangerous is a spinal cord injury?
Hematomyelia – in this case the hemorrhage occurs into the cavity of the spinal cord and formation of hematoma. Appear symptoms such as loss of pain and temperature sensitivity, which persisted for 10 days and then begin to regress. Well-organized treatment will restore lost and impaired function. But it is a neurological disorder in a patient can stay.
Damage to roots
Damage to the spinal roots – they manifest themselves in the form of paralysis or paresis of the extremities, autonomic disorders, reduce sensitivity, disorders of the organs of the pelvis. Common symptoms is dependent on which region of the spine affected. So, with the defeat of the collar area is the paralysis of the upper and lower extremities, difficulty breathing and loss of sensitivity.
- See also: What is a compression fracture of the spine?
Crushing injury – this injury is characterized by the violation of the integrity of the spinal cord, it is anguish. Within a certain period of time, up to several months can be kept symptoms of spinal shock. It becomes paralipomena extremities and reduction of muscle tone, loss of reflexes, both somatic and autonomic. The sensitivity is completely absent, the pelvic organs are functioning uncontrolled (involuntary defecation and urination).
Compression –this injury most often occurs as a result of fragments of vertebrae, articular processes, foreign bodies, intervertebral discs, ligaments, and tendons, damaging the spinal cord. This leads to partial or complete loss of motor activity of the limbs.
Injury – this type of injury is the paralysis or paresis of the limbs, lost sensitivity, muscles are weakened, disrupted pelvic. After the remedial measures these symptoms are eliminated completely or partially.
A concussion is a reversible dysfunction of the spinal cord, which is characterized by symptoms such as a decrease in muscle tone, partial or complete loss of sensation in those parts of the body corresponding to the level of damage. These forms of expression hold for a short time, after which the function of the spine is fully restored.
- See also: First aid for spinal injuries.
Spinal cord injury can be of different nature. So before you start therapeutic measures necessary not only to establish the fact of injury, but also to determine the degree of its severity. It is the responsibility of the neurosurgeon and neurologist. Today, medicine has sufficient funds for proper and accurate diagnostics of violations that occurred in connection with injuries of the spinal cord:
- Computer and magnetic resonance tomography;
- Lumbar puncture;
- Contrast myelography.
Computed tomography base on the effects of ionizing radiation and provides an opportunity to identify gross structural changes and possible foci of hemorrhage. Magnetic resonance diagnostics to determine the formation of swelling and bruising and damage to the intervertebral discs.
With the help of spondilography possible to detect such features of the injuries as fractures and dislocations of the vertebrae and arcs and transverse spinous processes. In addition, this diagnostic gives the full information on the condition of the vertebral joints, whether there is narrowing of the spinal canal, and if it is, then to what extent. Spondylography carried out in all cases of injury to the spinal cord and should be done in 2 planes.
- See also: inflammation of the spinal cord
A lumbar puncture is performed if there is suspected compression of the resulting injury. It consists in measuring the pressure of cerebrospinal fluid and assessment of patency of the subarachnoid space or the spinal canal. In case of confirmation of violations of the patency of performed myelography. It is performed by introduction of a contrast agent and so is determined by the degree of compression.
When injury to the spinal cord in the complex diagnostic procedures included assessment of functional and neurological disorders. Functional assessment is based on the ability of the victim to physical activity and the presence of sensation in various parts of the body. Neurologic abnormalities are evaluated by muscle strength. In addition, an indicator of motor disorders is the ability of independent movement of the hips, knee, feet, wrist, finger, thumb, elbow. These muscles correspond to the segments of the spinal cord.
Treatment and rehabilitation
Spinal trauma requires immediate treatment, because only then is it possible to save the motor activity of the affected person. Long-term effects of this injury will depend on how well and quickly were provided with qualified medical aid.
Tactics of treatment nature of care will depend on the severity of the injury. To prevent the catastrophic human consequences of spinal cord injury therapeutic measures should be undertaken in the following order:
- Almost immediately after the trauma the injection of drugs that will prevent necrosis of the nerve cells of the spinal cord.
- Surgical removal of the vertebral fragments compressing and tearing the spinal cord.
- Supply cells of the spinal cord sufficient oxygen to prevent further loss. This is done by restoring circulation.
- Reliable fixation of the vertebrae that was injured.
Surgical treatment is most effective if it was conducted in the first hours after the injury. Auxiliary medical treatment is carried out when signs of spinal shock. In this case, be applied Dopamine, Atropine, saline solutions. To improve blood circulation in the damaged spinal cord by intravenous administration of methylprednisolone.It helps to increase the excitability of neurons and conduction of nerve impulses. Needed medication that eases the effects of cerebral hypoxia.
Because the ability to regenerate the spinal nerve is absent, the use of stem cells will accelerate the patient's recovery.
In the postoperative period, pharmacological treatments used antibiotics to prevent bacterial infections, medications that stimulate the blood vessels, as after surgery high risk of thrombosis. Moreover, there are vitamins and antihistamines.
Injuries of this kind almost always entail serious consequences for the neuro-motor system. Therefore, an integral part of the treatment are restorative treatments, such as massage, physical therapy, muscle electrostimulation.