SPINAL TRAUMA

SPINAL TRAUMA2019-08-27T14:31:32+00:00

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 nearby bones, tissues, or blood vessels.

SYMPTOMS OF SPINAL TRAUMA

Symptoms vary, depending on the location of the injury. SCI causes weakness and loss of feeling at, and below the injury. How severe the symptoms are depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete).

An injury at and below the first lumbar vertebra does not cause SCI. But, it may cause cauda equina syndrome. This is an injury to the nerve roots in this area. This is a medical emergency and needs surgery right away. Injuries of the spinal cord 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

DIAGNOSIS OF SPINAL TUMOURS

The diagnosis of primary spinal cord tumors is difficult, mainly due to their symptoms, which in early stages mimic more common and benign degenerative spinal diseases. MRI and bone scanning are used for diagnostic purposes. This assesses not only the location of the tumor(s) but also their relationship with the spinal cord and the risk of cord compression.

When spinal cord injuries are in the neck area, symptoms can affect the arms, legs, and middle of the body. The symptoms:

May occur on 1 or both sides of the body
Can include breathing problems from paralysis of the breathing muscles, if the injury is high up in the neck

When spinal injuries are 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
Trouble maintaining normal temperature

When spinal injuries are at the lower back level, symptoms can affect one or both legs. Muscles that control the bowels and bladder can also be affected. Spine injuries can damage the spinal cord if they are at the upper portion of the lumbar spine or the nerve roots if they are at the lower lumbar spine.
CAUSES OF SPINAL TRAUMA

The spinal cord contains the nerves. These nerves carry messages between your brain and body. The cord passes through your neck and back down to the first lumbar vertebra.

Spinal cord injury (SCI) can be caused by anything from falls, work place and car accidents to sports injuries. A minor injury can damage the spinal cord. Conditions, such as rheumatoid arthritis or osteoporosis can weaken the spinal cord. Injury can also occur if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis). This occurs during normal aging.

Direct injury or damage to the spinal cord can occur due to:

Bruises if the bones or disks have been weakened
Fragments of bone (such as from broken vertebrae, which are the spine bones) in the spinal cord
Fragments of metal (such as from a traffic accident)
Sideway pulling or pressing or compression from twisting of the head, neck or back during an accident or intense chiropractic manipulation
Bleeding, fluid buildup, and swelling can occur inside or outside the spinal cord (but within the spinal canal). This can press on the spinal cord and damage it.

Most high impact SCIs, such as from motor vehicle accidents or sports injuries, are seen in young, healthy people. Men ages 15 to 35 are most often affected.

Low impact SCI often occurs in older adults from falls while standing or sitting. Injury is due to a weakened spine from aging or bone loss (osteoporosis).

DIAGNOSIS OF SPINAL TRAUMA

SCI is a medical emergency that needs medical attention right away. Your health care provider will perform a physical exam, including a brain and nervous system (neurological) exam. This will help identify the exact location of the injury, if it is not known. Some of the reflexes may be abnormal or missing. Once swelling goes down, some reflexes may slowly recover.

Tests that may be ordered include:

CT scan or MRI of the spine
Myelogram (an x-ray of the spine after injecting dye)
Spine x-rays
Electromyography (EMG)
Nerve conduction studies

TREATMENT OF SPINAL TRAUMA

An SCI needs to be treated right away. The time between the injury and treatment can affect the outcome. Medicines called corticosteroids are sometimes used to reduce swelling that may damage the spinal cord, though there is no clear evidence that they are useful.

If spinal cord pressure is caused by a growth that can be removed or reduced before the spinal nerves are completely destroyed, paralysis may improve.

Surgery may be needed to:

Realign the spinal bones (vertebrae)
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
Bed rest may be needed to allow the bones of the spine to heal.
Spinal traction may be suggested. This can help keep the spine from moving. The skull may be held in place with tongs. These are metal braces placed in the skull and attached to weights or to a harness on the body (halo vest). You may need to wear the spine braces for many months.

You will probably need physical therapy, occupational therapy, and other rehabilitation after the injury has healed. Rehabilitation will help you cope with the disability from your SCI.

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