The spinal cord is the main conduit of information and action between the brain and the rest of the body. A spinal cord injury can damage the spinal cord itself or the nerves at its end (Cauda equina).
The most common injuries to the spinal cord are due to fractures of the vertebral column. These injuries can be of the complete or incomplete kind. In case of complete injuries, the ability to control movement and sensations below the level of injury are lost totally (paraplegia or tetraplegia). Incomplete injuries however, have some sparing of motor and sensory function and have a better prognosis.
Signs and symptoms of a spinal cord injury include:
* Weakness, lack of co-ordination, or paralysis in any part of your body
* Neck or back pain with numbness, tingling, or loss of sensation in your hands, fingers, feet, or toes
* Loss of bladder or bowel control
* Difficulty with balance and walking
* Deformed or twisted position of the neck or back
* Difficulty in breathing, coughing or clearing secretions from your lungs
Common causes of a spinal cord injury are
* Motor vehicle accidents
* Sports injuries
* Gunshot injuries
* Complications of surgery
Management and treatment of spinal cord injury
Severe cases require critical care. In such situations, hospitalization where medical care is available full time, is essential where the patient is continuously monitored for better recovery.
CT scan, MRI scan and X-rays help show the extent of the injury inside. They also help in deciding if the patient needs surgery for the same. Surgery, medication, and rehabilitation therapy are the current mainstays of treatment and offer a better quality of life in most patients with spinal cord injury.
With modern surgical tools, robotics and 3D navigation, surgeries have become safer. Minimally invasive surgery has also further reduced the footprint of spine surgery. This reduces the burden on the patient’s physiology facilitating early recovery. The surgical goal is to stabilize and decompress the vertebral column and spinal cord allowing early mobilization.
Early rehabilitation improves outcomes and prevents some complications. All patients need rehabilitation after spinal cord injury from a team of physical/occupational and speech therapists to get back to activities of daily living independently or with minimal assistance.
The long-term goals include improving independence, reducing chronic health issues and restore at least some function in incomplete injuries.
Also read: A spinal cord injury survivor reconnects to her body through dance on her ‘hot wheels’
The role of robotics
Robotics has changed the way rehabilitation is done nowadays. Neural prosthesis and exo-skeletons are now giving mobility and control to those who are completely paralyzed.
Those with spinal cord injuries need a good surgical and rehabilitation team along with support groups and family training. Continuous vigilance to prevent bed sores, venous thrombosis, lung infections and joint contractures is needed.
Disable friendly infrastructure, organizational inclusiveness and skills retraining will go a long way in making them self-sufficient.