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Spinal cord injuries are most often the result of injuries, although they may also occur as a result of the development of a tumor within the spinal canal or constitute a complication of a medical procedure. The spinal cord is a delicate structure and its damage is dangerous, primarily because it is very rarely possible to reverse functional deficits caused by an injury to this structure.

The most commonspinal cord injuries(due to the most common factor causing this condition) are observed in young men. Contrary to appearances, the problem is quite common - in the United States alone, according to statistics, more than 10,000 people experience spinal cord injuries every year. The spinal cord is a structure that, next to the brain, belongs to the central nervous system. There are centers through which the movement of muscles is controlled, as well as zones that deal with receiving sensory stimuli from various parts of the body. In addition to those mentioned, the spinal cord is also a structure related to, inter alia, Given the wide range of functions performed by the spinal cord, it is fairly easy to conclude that damage to this structure can lead to many different serious consequences.

Spinal cord injuries: causes

The most common causes of spinal cord injury are injuries. Both traffic accidents and an unfortunate jump into a shallow water reservoir or beating can lead to disorders of the spinal cord. However, there are many other conditions that can lead to spinal cord injury, for example:

  • ischemia of the spinal tissues
  • vertebral fractures due to osteoporosis
  • iatrogenic injuries (i.e. complications of medical procedures, e.g. lumbar puncture)
  • tumors that develop within the spinal cord or compress the spinal cord
  • inflammatory diseases of the spinal cord

Some patients are predisposed to developing spinal cord injury. Although in most people this risk is not significantly increased, it is in some way increased - we are talking about patients suffering from stenosis (narrowing) of the canalcord.

Spinal Cord Injuries: Symptoms

A patient's symptoms of the spinal cord are closely related to the level at which the spinal cord has been damaged. The spinal cord is divided into segments and in this division it is distinguished:

  • eight cervical segments (C1 to C8)
  • twelve thoracic segments (Th1 to Th12)
  • five lumbar segments (from L1 to L5)
  • five cross segments (S1 to S5)
  • one cusp segment

Generally, the higher the lesion is, the wider the range of disorders is. In a situation where the injury affects the part of the spine above the C4 level, the patient most often dies as a result of paralysis of the respiratory muscles. Damage between C4 and C5 leads to tetraplegia, i.e. paralysis of all limbs in the patient. In the case of a defect between C6 and C7, the upper limbs are paralyzed and the lower limbs are paralyzed. The defect located between C7 and Th11 results in various degrees of paralysis of the lower limbs. In contrast, trauma to the Th12-L1 segments leads primarily to paralysis of the sphincter function. Above are the most characteristic features of damage to certain levels of the spinal cord. In the course of these states, various other problems may also appear, such as:

  • sensory disturbances (concerning all kinds of it or in the form of isolated disturbances of the sense of touch, pain or temperature)
  • excessive tendon reflexes
  • sexual dysfunction (e.g. impotence)
  • pain ailments
  • breathing disorders
  • impaired motor coordination and balance
  • paresthesia (e.g. numbness or tingling)

Spinal cord injuries: types

The basic division of spinal cord injuries distinguishes partial and complete injuries. In the case of complete spinal damage, there are movement disorders and sensory disturbances below the site of the existing defect. Partial lesions are slightly milder, because in their case the above-mentioned functions are weakened, however, they are not completely abolished - patients may, for example, be able to perceive one of the types of feeling. An example of a partial spinal cord injury is Brown-Sequard syndrome (transverse spinal cord injury syndrome) in which there is a spastic paralysis and an abolition of deep sensation on the side of the lesion and an abolition of pain and temperature on the opposite side.Spinal cord injuries can also be classified using the so-called Frankel scale, which is distinguished by 5 degrees:

  • A: complete damage to the spinal cord leading to paralysis and decay
  • B: abolishing the ability to perform movements with retained (at least gradually) feeling
  • C: it is possible for the patient to make movements, but they are chaotic and pointless, feeling can be preserved, but also suppressed
  • D: there is a varying degree of muscle paresis, however, the patient is able to make any deliberate movements
  • E: the patient has no neurological defects

Spinal Cord Injuries: Diagnosis

If a spinal cord injury is suspected, the most important are neurological examination and imaging diagnostics. The former are used to determine what neurological deficits are present in a patient. On the basis of the changes found, it is possible to make an assumption as to which part of the spinal cord was damaged. Imaging diagnostics, in turn, is used to more precisely determine the nature of the damage. Basic changes (such as fractures of the vertebrae of the spine) can sometimes be visualized even by X-ray of the spine, but more accurate methods used in patients with spinal cord injury are computed tomography and magnetic resonance imaging - the mentioned ones allow to visualize the tissues of the spinal cord.

Spinal Cord Injuries: Treatment and Prognosis

The spinal cord, unfortunately, does not have the ability to regenerate. If it is damaged, then - at least at present - medics are basically unable to reverse the disorders. Attempts are being made to administer glucocorticosteroids to patients early (within eight hours of the injury), but this method is debatable due to the different effects of such procedures - some patients achieve some degree of improvement, while others do not. changes their prognosis. Nowadays, scientists are trying to find a method to regenerate the tissues of the spinal cord. The use of stem cells for this purpose is seen as a great opportunity, but currently such therapies are only at the research stage. The exact treatment of a patient after spinal cord injury depends on what led to the condition. If, for example, the patient has had an accident and has fractures of the spine, it may be necessary to undergo surgery.neurosurgical. When the patient's life is no longer threatened, then - as soon as possible - rehabilitation is implemented to prevent, for example, contractures or muscle atrophy. The prognosis of patients with the most severe, i.e. complete forms of spinal cord injury, is not good. It is not impossible to regain some degree of fitness, although it is estimated that the chances of patients returning to even something similar to normal functioning reach a maximum of 5%.

Important

Spinal Cord Injuries: First Aid

When you see a conscious patient who may have had spinal cord injury, there is one key rule to remember - such a patient must not be moved. For if such a person had, for example, fractures within the spine, movement could displace fragments of the fragments, which could potentially increase the degree of spinal cord damage. In such a situation, first of all, you should call an ambulance - specialists will be able to properly immobilize the patient and safely transport him to the hospital.

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Category:

Neurology