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SPINAL CORD INJURY


   Dr. Jayesh Patidar
   PhD.,M.Sc. Nursing
What is the spinal cord?

  The spinal cord is a collection of nerves that
 travels from the bottom of the brain down your
 back. There are 31 pairs of nerves that leave the
 spinal cord and go to arms, legs, chest and
 abdomen. These nerves allow your brain to give
 commands to your muscles and cause
 movements of your arms and legs.
The spinal cord is very sensitive to injury. Unlike
other parts of your body, the spinal cord does not
have the ability to repair itself if it is damaged.
DEFINITION
 A spinal cord injury occurs when there is damage
 to the spinal cord either from trauma, loss of its
 normal blood supply, or compression from tumor
 or infection
 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 surrounding
 bones, tissues, or blood vessels.
Incidence
 There are approximately 10,000 new cases of
 spinal cord injury each year in the United States.
 They are most common in white males.
 Specifically, 80% of spinal cord injuries occur in
 males, and 2/3 occur in whites. Most injuries
 occur in patients 16-30 years of age.
Causes and risk factors

 Spinal cord trauma can be caused by a number of
    injuries to the spine, including:
   Assault
   Falls
   Gunshot wounds
   Industrial accidents
   Motor vehicle accidents
   Sports injuries (particularly diving into shallow water)
   A minor injury can cause spinal cord injury if the spine
    is weakened (such as from rheumatoid
    arthritis or osteoporosis) or if the spinal canal
    protecting the spinal cord has become too narrow
    (spinal stenosis) due to the normal aging process.
Spinal cord injuries are described as either
  complete or incomplete.
 In acomplete spinal cord injury there is
  complete loss of sensation and muscle function in
  the body below the level of the injury.
 In an incomplete spinal cord injury there is
  some remaining function below the level of the
  injury. In most cases both sides of the body are
  affected equally.
 An injury to the upper portion of the spinal cord in
 the neck can cause quadriplegia-paralysis of
 both arms and both legs. If the injury to the spinal
 cord occurs lower in the back it can
 cause paraplegia-paralysis of both legs .
CERVICAL (NECK) INJURIES
 When spinal cord injuries occur in the neck
  area, symptoms can affect the arms, legs, and middle
  of the body. The symptoms may occur on one or both
  sides of the body. Symptoms can also include
  breathing difficulties from paralysis of the breathing
  muscles, if the injury is high up in the neck.
THORACIC (CHEST LEVEL) INJURIES
 When spinal injuries occur 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, and trouble
  maintaining normal body temperature.
LUMBAR SACRAL (LOWER BACK) INJURIES
 When spinal injuries occur at the lower back
  level, symptoms can affect one or both legs, as
  well as the muscles that control the bowels and
  bladder.
Symptoms

  Injuries 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
Signs and tests

 Spinal cord injury is a medical emergency that
  needs immediate medical attention.
 The health care provider will perform a physical
  exam, including a brain and nervous system
  (neurological) exam..
The following tests may be ordered:
 CT scan or MRI of the spine
 Myelogram (an x-ray of the spine after injecting
  dye)
 Spine x-rays
Treatment

 A spinal cord injury is a medical emergency that
  needs to be treated right away. The time between
  the injury and treatment can affect the outcome.
 Corticosteroids, such as dexamethasone , are
  used to reduce swelling that may damage the
  spinal cord.
 If spinal cord pressure is caused by a growth that
  can be removed or reduced before spinal nerves
  are completely destroyed,paralysis may improve.
  Ideally,
 corticosteroids should begin as soon as possible
  after the injury.
 Bed rest may be needed to allow the bones of the
  spine to heal.
 Spinal traction may be recommended. This can
  help keep the spine from moving.
 The health care team will also provide information
  on muscle spasms, care of the skin, and bowel and
  bladder dysfunction. skin will be protected against
  pressure sores.
 You will probably need physical therapy, occupational
  therapy, and other rehabilitation therapies after the
  injury has healed. Rehabilitation will help cope with
  the disability from spinal cord injury.
 Muscle spasticity can be relieved with medications
  taken by mouth or injected into the spinal canal. Botox
  injections into the muscles may also be helpful.
 Painkillers (analgesics), muscle relaxers, and
  physical therapy are used to help control pain.
Surgery may be needed to:
 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.
Complications
 These complications include:
 urinary tract infections or urinary
    incontinence (inability to control the flow of urine),
   bowel incontinence (inability to control bowel
    movements),
   pressure sores,
   infections in the lungs (pneumonia),
   blood clots,
   muscle spasms,
   chronic pain, and
   depression.
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Spinal coard injury

  • 1. SPINAL CORD INJURY Dr. Jayesh Patidar PhD.,M.Sc. Nursing
  • 2. What is the spinal cord? The spinal cord is a collection of nerves that travels from the bottom of the brain down your back. There are 31 pairs of nerves that leave the spinal cord and go to arms, legs, chest and abdomen. These nerves allow your brain to give commands to your muscles and cause movements of your arms and legs.
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  • 5. The spinal cord is very sensitive to injury. Unlike other parts of your body, the spinal cord does not have the ability to repair itself if it is damaged.
  • 6. DEFINITION  A spinal cord injury occurs when there is damage to the spinal cord either from trauma, loss of its normal blood supply, or compression from tumor or infection
  • 7.  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 surrounding bones, tissues, or blood vessels.
  • 8. Incidence  There are approximately 10,000 new cases of spinal cord injury each year in the United States. They are most common in white males. Specifically, 80% of spinal cord injuries occur in males, and 2/3 occur in whites. Most injuries occur in patients 16-30 years of age.
  • 9. Causes and risk factors  Spinal cord trauma can be caused by a number of injuries to the spine, including:  Assault  Falls  Gunshot wounds  Industrial accidents  Motor vehicle accidents  Sports injuries (particularly diving into shallow water)  A minor injury can cause spinal cord injury if the spine is weakened (such as from rheumatoid arthritis or osteoporosis) or if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis) due to the normal aging process.
  • 10. Spinal cord injuries are described as either complete or incomplete.  In acomplete spinal cord injury there is complete loss of sensation and muscle function in the body below the level of the injury.  In an incomplete spinal cord injury there is some remaining function below the level of the injury. In most cases both sides of the body are affected equally.
  • 11.  An injury to the upper portion of the spinal cord in the neck can cause quadriplegia-paralysis of both arms and both legs. If the injury to the spinal cord occurs lower in the back it can cause paraplegia-paralysis of both legs .
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  • 14. CERVICAL (NECK) INJURIES  When spinal cord injuries occur in the neck area, symptoms can affect the arms, legs, and middle of the body. The symptoms may occur on one or both sides of the body. Symptoms can also include breathing difficulties from paralysis of the breathing muscles, if the injury is high up in the neck. THORACIC (CHEST LEVEL) INJURIES  When spinal injuries occur 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, and trouble maintaining normal body temperature.
  • 15. LUMBAR SACRAL (LOWER BACK) INJURIES  When spinal injuries occur at the lower back level, symptoms can affect one or both legs, as well as the muscles that control the bowels and bladder.
  • 16. Symptoms  Injuries 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
  • 17. Signs and tests  Spinal cord injury is a medical emergency that needs immediate medical attention.  The health care provider will perform a physical exam, including a brain and nervous system (neurological) exam.. The following tests may be ordered:  CT scan or MRI of the spine  Myelogram (an x-ray of the spine after injecting dye)  Spine x-rays
  • 18. Treatment  A spinal cord injury is a medical emergency that needs to be treated right away. The time between the injury and treatment can affect the outcome.  Corticosteroids, such as dexamethasone , are used to reduce swelling that may damage the spinal cord.  If spinal cord pressure is caused by a growth that can be removed or reduced before spinal nerves are completely destroyed,paralysis may improve. Ideally,  corticosteroids should begin as soon as possible after the injury.
  • 19.  Bed rest may be needed to allow the bones of the spine to heal.  Spinal traction may be recommended. This can help keep the spine from moving.
  • 20.  The health care team will also provide information on muscle spasms, care of the skin, and bowel and bladder dysfunction. skin will be protected against pressure sores.  You will probably need physical therapy, occupational therapy, and other rehabilitation therapies after the injury has healed. Rehabilitation will help cope with the disability from spinal cord injury.  Muscle spasticity can be relieved with medications taken by mouth or injected into the spinal canal. Botox injections into the muscles may also be helpful.  Painkillers (analgesics), muscle relaxers, and physical therapy are used to help control pain.
  • 21. Surgery may be needed to:  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.
  • 22. Complications  These complications include:  urinary tract infections or urinary incontinence (inability to control the flow of urine),  bowel incontinence (inability to control bowel movements),  pressure sores,  infections in the lungs (pneumonia),  blood clots,  muscle spasms,  chronic pain, and  depression.