They are injuries in which damage to a region of the spinal cord or the nerves in the last part of the spinal canal for certain reasons causes permanent changes in the power, sense and functions of other body organs. The area of the body that is affected by a spinal cord injury is the lower part of the injury.

 

Scientific research shows optimistic results about spinal cord repair. Surgical procedures and physical rehabilitation as a result of injury give effective results in providing a more independent life.

 

Symptoms

The control ability of the limbs after spinal cord injury depends on where the damage occurs in the spinal cord and its severity. Depending on the severity of the injury, the damage can be "complete" or "partial".

• Complete injury: All the parts below the damaged area. loss of sensation and function in these regions.

• Partial injury: in the lower area of the damaged area If there is a partial sensory and movement function, it is also a partial spinal cord injury.

A series of tests will be performed to determine the neurological level and integrity of the injury. Any spinal cord injury shows one or more of the following symptoms:

• loss of movement

• Losing senses of cold, heat, and touch

• Loss of bowel or bladder control

• exaggerated reflexes or spasms

• Changes in fertility with changes in sexual function and sensitivity

• Pain or an intense stinging sensation due to damage to nerve fibers in the spinal cord

• such as difficulty breathing and coughing

 

Sudden onset of symptoms

Immediate signs of spinal cord injury following any accident may include:

• weakness, incoordination, or paralysis in any part of your body

• Numbness, tingling, or loss of feeling in the hands, fingers, feet, or toes

• Loss of bladder or bowel control

• Difficulty balancing and walking

• Abnormal breathing after injury

• Neck or back is awkwardly positioned or twisted

• Pain or pressure in the neck, head, or back area

 

Immediate medical attention is essential because there is a risk of spinal cord injury in people who have had severe trauma affecting the head and neck region. In cases such as traffic accidents and fire, if it is necessary to move the injured person until the emergency service arrives, this risk should be considered due to the following situations:

• Serious spinal cord injury is not always completely obvious. More serious injuries may occur because it is not noticed from the outside.

• Numbness or paralysis may occur in a short time, or it may occur gradually due to bleeding or swelling in and around the spinal cord.

• The time between injury and treatment is critical in determining the extent of complications and the amount of recovery.

 

If you suspect someone has suffered a back or neck injury:

• Do not move the injured person. Otherwise, permanent paralysis and other serious complications may occur.

• call 112

• Keep the person still until the emergency services arrive.

• Put things such as towels on both sides of the neck and ensure that the head and neck are fixed until the emergency service arrives.

• Perform first aid interventions such as stopping bleeding without moving the head or neck and ensure that the person is comfortable.

 

Reasons

Spinal cord injuries are caused by damage to the spine, ligaments, spinal discs, or the spinal cord itself. A traumatic spinal cord injury is commonly caused by sudden blows, bumps, crushes, fractures, or spinal compressions. Apart from these, there are also reasons such as gun or knife wounds that cause the spinal cord to be cut. Some other spinal cord injuries occur as a result of bleeding, swelling, fluid accumulation and inflammation in the related area in the following days and weeks.

 

Non-traumatic spinal cord injury can result from arthritis, cancer, inflammation, infection, or spinal disc degeneration.

 

The most common causes of spinal cord injuries are:

• Motor vehicle accidents: Automobile and motorcycle accidents are among the leading causes of spinal cord injuries. It is around 40%.

• Falls: Spinal cord injuries after the age of 65 are most commonly caused by falls. Approximately 25% of spinal cord injuries are in this group.

• Acts of violence: Approximately 15% of spinal cord injuries are caused by violence involving firearms and stab wounds.

• Sports injuries: Sports branches where players are likely to be hit and athletic activities such as diving in shallow water cause approximately 8% of spinal cord injuries.

• Alcohol: Alcohol use is also a common cause of spinal cord injuries.

• Diseases: Cancer, arthritis, osteoporosis (bone loss) and spinal cord inflammation are among the factors that cause spinal cord injuries.

 

While spinal cord injuries are usually the result of an accident and can happen to anyone, certain factors increase the risk:

• Being male: Spinal cord injuries are more common in males. For example, only 20 percent of traumatic spinal cord injuries in the United States occurred in women.

• Being between the ages of 16 and 30: Traumatic spinal cord injury is more common in this age range. Motor vehicle crashes are the most common cause for people under the age of 65, while injuries from falls are more common for seniors over this age.

• Risky behaviors: Diving in very shallow waters, not using the appropriate safety gear for the sport or not taking the necessary precautions are the causes of sports-related spinal cord injuries.

• A bone or joint disorder: Spinal cord injury is more common in those with other relatively minor disorders affecting the bones or joints, such as arthritis or osteoporosis, due to the high risk of fractures of bones or mechanical compression.

 

Consequences of Injury

In the beginning, the deterioration and decline in body functions due to spinal cord injury can pull the person into a psychological process that is difficult to overcome. However, rehabilitation services can provide beneficial results for recovery and recovery in your body functions. Some complications that occur as a result of spinal cord injury and which are tried to be corrected with rehabilitation are as follows:

• Bladder control: The bladder will continue to receive urine from the kidneys. However, bladder control may not occur because the nerves that carry messages between the bladder and the brain cannot communicate due to spinal cord injury. Changes in bladder control increase the risk of urinary tract infections. This condition can cause kidney infections, kidney stones or bladder stones. Consuming plenty of pure liquid will help prevent stone formation. Also, useful techniques for emptying the bladder during rehabilitation are taught.

• Bowel control: Although the stomach and intestines may function as they did before the injury, problems may occur in maintaining stool control. Diets containing high-fiber foods and rehabilitation techniques will help regulate the bowels.

• Skin sensitivity: Skin sensation may be lost in some or all of the areas below the nerve damage area. Therefore, messages about long-term pressure, heat and cold cannot be transmitted from the skin to the brain. Changing positions frequently to prevent long-term pressure on a part of the body can help prevent scar formation due to pressure.

• Circulatory control: A spinal cord injury can cause circulatory problems such as limb swelling (orthostatic hypotension) and low blood pressure. These circulatory problems can also increase the risk of developing a blood clot such as a deep venous thrombosis or pulmonary embolism. Another potential risk associated with circulation is a rise in blood pressure (autonomic hyperreflexia).

• Respiratory system: If the chest and abdomen are affected as a result of injury, breathing may be difficult and cough may be experienced. The muscles affected are the chest wall and abdominal diaphragm muscles. The neurological dimension of the injury will determine the severity of respiratory problems. If there is cervical and thoracic cord injury, there is a risk of pneumonia and other lung problems.

• Muscle tone: People with spinal cord injuries may experience two types of muscle tone problems: uncontrolled tension—muscle movement (spasticity) or a lack of muscle tone (laxity) with soft-to-loose muscles.

• Inactivity: Weight loss and muscle atrophy are common after spinal cord injury. Limited mobility leads to a more sedentary lifestyle, increasing the risk of obesity, cardiovascular disease and diabetes. At this point, the recommendations of dietitians and physical therapy rehabilitation specialists are important.

• Sexual health: Sexuality, fertility and sexual functions can be adversely affected by spinal cord injury. Erection and ejaculation disorders in men and some other genital problems may occur in women. Physicians, urologists and obstetricians specializing in spinal cord injury will present options for sexual function and fertility. There are usually no physical changes that prevent sexual intercourse or pregnancy in women who have had a spinal cord injury. After the injury, most women are able to give birth and breastfeed normally.

• Pain: Some people may develop muscle or joint pain after overuse of certain muscle groups. Also known as neuropathic pain or central nerve pain, it can occur especially after partial spinal cord injury.

• Depression: Physiological and psychological changes that occur after spinal cord injury cause depression symptoms in some people.

 

Diagnosis

A detailed neurological examination is performed to determine the level of injury and the condition of the spinal cord. While the patient is being checked by a doctor, it is tried to understand whether the spinal cord is affected by testing sensory function and mobility and asking some questions about the accident. However, if the injured person complains of neck pain, is not fully awake, and has obvious signs of weakness or neurological injury, emergency diagnostic tests may be required. These tests include:

• X-ray: This test is usually applied to people with suspected spinal cord injury after a trauma. X-rays can reveal spinal problems, tumors, fractures or degenerative changes.

• Computed tomography: More detailed results can be obtained with CT scans than with X-ray scans. Using the computer, multiple cross-sectional images are obtained to diagnose problems with bones, discs and other parts.

• Magnetic resonance (MR): Images are obtained with computer support using a strong magnetic field and radio frequencies. With this test, soft tissues are better evaluated. The condition of the spinal cord can be looked at, it is also very useful for identifying herniated discs, blood clots or other masses that are pressing on the spinal cord.

 

Treatment

Unfortunately, there is currently no way to completely reverse the damage to the spinal cord. However, ongoing research is working on treatments that can stimulate the regeneration of nerve cells after spinal cord injury or increase the function of nerves left after damage. Today, treatment for spinal cord injury aims to prevent further injury and return the person to an active and productive life.

 

Emergency Response: Immediate medical attention is essential to minimize any traumatic effects on the head or neck. Therefore, treatment for a spinal cord injury usually begins at the scene of the accident. Emergency service personnel usually pay attention to the immobility of the spine and use a rigid neck brace and stretcher while transporting the patient to the hospital. While performing diagnostic tests, the patient is kept still due to the risk of spinal cord injury. If spinal cord injury is detected after diagnostic tests, the patient is usually taken to the intensive care unit. Depending on the situation, it may be necessary to be referred to a center where neurosurgeons, orthopedic surgeons, spinal cord medicine specialists, psychologists, nurses and therapists are experts in spinal cord injury.

 

Surgery may be required for purposes such as removal of bone fractures, foreign bodies, herniated disc, and removal of vertebral fractures. In addition, surgery may be necessary to prevent future pain or structural disorders and to stabilize the spine.

Once the disease has stabilized, doctors turn to preventing secondary problems that may arise such as condition, muscle contractures, pressure ulcers, bowel and bladder problems, respiratory infections, and blood clots. The length of stay in the hospital varies depending on the patient's condition and the medical procedures applied. After an appropriate phase of treatment, the patient is referred to the rehabilitation center when ready.