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Spine Disorders
Spinal Cord Injury
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WHEN TO SEEK MEDICAL ADVICE Spinal cord injury may not always be obvious. The initial signs/symptoms may involve more subtle numbness and/or muscle weakness and progress as bleeding and/or swelling occurs in or around the spinal cord. Anyone who has suffered a significant trauma to the head or neck requires immediate medical attention to rule out the possibility of a spinal cord injury. It is prudent to assume that trauma victims have suffered a spinal cord injury until proven otherwise. The time between injury and treatment is critical factor that can alter the outcome and the level of residual disability or impairment. SCREENING AND DIAGNOSIS The assessment of potential or actual spinal cord injury involves the use of one or more of the following procedures:
The evaluation process and diagnosis should not stop with the initial workup. Follow up evaluation is required to determine the severity of injury and to assess the level of recovery. NATURAL HISTORY AND PROGNOSIS Spinal cord injuries are classified as either complete or incomplete.An incomplete injury means that the ability of the spinal cord to convey messages to or from the brain is not completely lost. People with incomplete injuries retain some motor or sensory function below the injury. A complete injury is indicated by a total lack of sensory and motor function below the level of injury.People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel dysfunction, along with an increased susceptibility to respiratory and heart problems. Successful recovery depends upon how well these chronic conditions are handled day to day. COMPLICATIONS People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel dysfunction, along with an increased susceptibility to respiratory and heart problems. Successful recovery depends upon how well these chronic conditions are handled day to day. Breathing Any injury to the spinal cord at or above the C3, C4, and C5 segments, which supply the phrenic nerves leading to the diaphragm, can stop breathing. People with these injuries need immediate ventilatory support. When injuries are at the C5 level and below, diaphragm function is preserved, but breathing tends to be rapid and shallow and people have trouble coughing and clearing secretions from their lungs because of weak thoracic muscles. Once pulmonary function improves, a large percentage of those with C4 injuries can be weaned from mechanical ventilation in the weeks following the injury. |
