What is Spinal Cord Injuries?
Spinal cord injuries or damage occurring to the spinal cord or nerves located at the end of the spinal canal (channel) of the spine. This condition can have a permanent effect on the strength, sensation and function of other organs that lie beneath the injured area. This can change the total life of the sufferer, especially in his daily life.
The spinal cord serves to bridge the message signals from the brain to other organs. Based on the type of message sent, there are two groups of nerve cells, the motor nervous group and the sensory nerve group. Motor nervous groups are nerve cells that carry signals from the brain to control muscle movement. Groups of sensory nerves are nerve cells that carry signals from the brain to control limb position, as well as sensations associated with pain, cold, heat, and pressure.
Causes of Spinal Cord Injury
Spinal cord injuries can be caused by damage to the spine, ligaments, spinal cord or spinal cord itself. Because of its function as a message bridge between the brain and body, injury to the spinal cord may affect some or all of the nerve cells and body parts associated with the damaged area.
For example, injuries to the lower back may affect nerve cells and organ functions such as the limbs, the trunk including internal organs such as the bladder, and sexual organs. Spinal cord damage can be triggered by a traumatic (primary) or nontraumatic (secondary) cause experienced by the spine. Some examples of causes include:
- Motor vehicle accident. Accidents are the most common cause of this condition.
- Elderly, especially those over 65, have a risk of spinal cord injury from falling. Sport or injury during recreation. Some athletic activities such as, diving in shallow waters, riding, skiing, skateboarding, and others are at risk of causing spinal cord injuries when dropped.
- Violence. Injuries can start from gunshot wounds and stab wounds that cut or injure the spinal cord.
- Disease. This condition can be triggered by nontraumatic injuries, such as from cancer, arthritis, inflammation, osteoporosis, bone or joint disorders, and an infection or decrease in the number of spinal discs.
- Alcohol. Excessive use of alcohol is one of the common causes of spinal cord injury.
Although spinal injuries are usually due to accidents that can affect everyone, there are several risk factors that increase the occurrence of this condition. Several risk factors for spinal cord injury, among others:
- Age. The age range of 16-30 years is age susceptible to traumatic injury to the spinal cord. Likewise, elderly people aged over 65 years are vulnerable to injury from falling.
- Gender. Spinal cord injuries are more common in men than in women.
- Often do activities that risk falling.
- Has bone or joint disorders.
Symptoms of Spinal Cord Injury
As mentioned earlier, injury to the spinal cord may affect motor and sensory functions of the body. From pain, numbness, to paralysis. This depends on the severity and location of the injury. Injury severity level is divided into two, namely:
- Complete or complete. This level of injury involves the loss of all sensory abilities and the ability to control the movement (motoric) of the injured spinal area.
- Local or incomplete. Occurs when there are still some sensory or motor functions that work. These types of injuries have varying degrees of severity.
In addition, paralysis due to spinal injury can be categorized into:
- Tetraplegia or quadriplegi, which can affect the four limbs, chest and abdomen.
- Paraplegia, which affects the lower limbs and pelvic organs.
Spinal cord injuries can have one or more of the following symptoms:
- Loss of ability to feel touch, heat, and cold.
- Unable to move.
- Pain or sting as a result of damage to the spinal cord fibers.
- Difficulty coughing, breathing, also difficult to remove fluid from the lungs
- Loss of control of the body processes associated with the bowel and bladder, such as difficulty in urinating or large.
- Changes related to sexual activity, sexual function, and fertility.
- Experiencing excessive reflexes or spasms.
Beware of emergency symptoms that arise after the accident as an indication of the presence of injuries to the spinal cord, namely:
- Pain or pressure on the neck, head, or back is severe.
- Tingling or numbness in fingers, hands, toes, or feet.
- Respiratory disturbances after an accident.
- Difficult to maintain body balance when walking.
- Parts of the body become weak, uncoordinated, or paralyzed. This condition can also appear after bleeding or swelling around the spinal cord occurs.
- The position of the neck or back is twisted in an abnormal direction. Immediately contact your doctor if the person who has just had an accident on the head or neck shows symptoms of spinal cord injury as above. This condition can be dangerous because there is a possibility of a more serious injury.
Diagnosis of Spinal Cord Injury
A series of interviews and tests that test motor and sensory function will be performed by the doctor as a first step in getting a diagnosis of a spinal cord injury. A series of tests can be done in an emergency if the patient with a neck injury is unconscious or has symptoms of nerve injury. Some tests that may be done, among others:
- X-rays, to check the condition of the spine from possible cracks, tumors or other disorders.
- CT scan, to get a clearer picture of the spine and to know what kind of disorder it is experiencing.
- MRI, to check the condition of the spinal cord using strong magnetic and radio waves. This examination can help doctors get information whether there is a blood clot or other conditions that cause pressure on the spinal cord.
- Neural tests may be performed to determine the severity of the injury. One of them by testing the muscle strength and ability of patients respond to stimulation in the form of a touch or a needle puncture.
Treatment of Spinal Cord Injuries
The break between injury and treatment of spinal cord injury can affect the type of complications that will develop and the patient’s recovery time. Handling is also done to minimize the effects of head and neck trauma. Therefore, the handling of nerve injuries often has started from the scene. Unfortunately, until now there is still no way to restore spinal cord function that has been damaged. Researchers are still trying to find new therapies, including prostheses and drugs that promote growth or repair of nerve cells.
Some stages of treatment of spinal cord injury, namely:
The initial stages of treatment are done to prevent shock, and keep the patient breathing. Immobilization of the neck is also done to prevent further damage to the spinal cord, and prevent complications. The initial treatment consists of:
- Neck protectors are useful for maintaining the balance of the neck with the spine.
- Surgery may be performed to remove part of the bone, pieces, spine cracks, or other objects that push the spine. Surgery is also possible to prevent pain and deformity / bone defects.
- Medication of methylprednisolone in liquid injection form. These drugs can be injected into the blood vessels to treat acute spinal cord injuries.
- The goal is to reduce damage to nerve cells and inflammation around the injury area if given within 8 hours after injury occurs.
- Treatment of experiments. Research on the latest treatments that continue to be done to date. The goal controls inflammation, stops cell death, and stimulates nerve cell regeneration.
The second stage of treatment of spinal cord injury is to prevent the emergence of further conditions or complications resulting from this injury, such as respiratory infections, muscle contractures, intestinal and bladder disorders, tissue damage from immobilization (decubitus), and blood clots. Once the patient’s condition is deemed ready for further treatment and therapy, the patient will begin the rehabilitation phase.
The third stage or rehabilitation aims to educate the patient about the impact of this injury, how to deal with it, and of course physical recovery. The patient will be taught to re-build a productive life by utilizing his new abilities. Patients are trained to maintain and strengthen existing muscle function, restore impaired fine motor function, and learn techniques to adapt to daily activities.
Treatment at the rehabilitation stage is given to overcome the pain, controlling the effects of spinal cord injuries on the functioning of the gastrointestinal organs. It also serves to control muscle flexibility.
Some modern equipment or technology may also be used by spinal cord injuries to facilitate their physical recovery process, such as:
- Electric wheelchairs or those with lighter material than their predecessor’s wheelchairs can help the patient undergo activities without having to rely on others.
- Electronic equipment that can be operated using sound or buttons can help patients perform activities or daily routine.
- Electrical functional stimulators (FES) are used to control the muscles of the hands and feet so that the patient can walk or hold on.
- Use the help of robots to retrain the ability to walk after the patient has a spinal cord injury. This equipment is still a new breakthrough that still needs to be refined.
- Computers that can be activated using a speech recognition program can be used by patients who have limited hand organ function due to this injury
Recovery of spinal cord injuries can be rapid and prolonged. In some cases, recovery may occur piecemeal, starting from one week to 6 months, may also take up to a year or longer.
Complications of Spinal Cord Injuries
Spinal cord injuries have a major impact on how the body performs its functions. Some of the changes and complications that participate experienced by other organs, namely:
- The ability of the skin to feel pressure, cold feeling or heat that is blocked by this condition makes the patient vulnerable to injury or pain in areas of the skin that are under excessive pressure and exposed to heat or cold.
- Urine removal from the bladder is difficult to control as nerve cells that serve as messengers have been injured. This condition can trigger urinary tract infections, kidney, and bladder stones. The rehabilitation process will help the patient to learn how to control the post-injury bladder.
- Reduced body control for large disposal processes.
Increased blood pressure or vice versa, decreases as it rises from a sitting position, to swelling of the legs that can trigger blood clots, such as deep vein thrombosis.
- Muscle spasms or uncontrolled muscle tone (spasticity), or vice versa, muscle weakness due to reduced strength (flasidity).
- Respiratory disturbances as a result of the influence of spinal cord injuries on the abdominal and chest muscles.
- Weight loss and muscle degeneration can limit body movements which are then at risk for obesity, diabetes, and cardiovascular disease.
- Muscle pain, joints or nerves in muscles that are too often used in patients with spinal cord injury is not complete.
- Sexual health, such as sexual organ function, fertility rate, and sexual arousal may be affected as a result of this condition.
- Depression can arise from having to go through the changes experienced by the body and the pain of this condition.
Prevention of Spinal Cord Injuries
Preventing spinal cord injury can be done through the following preventive measures:
- Stay alert and cautious while exercising or doing other risky activities. Use safety equipment, such as a helmet, while doing some sport.
- Note the surroundings to prevent falling. Use an extra handle on the stairs, or an antiselip mat to prevent slipping while in the shower.
- Adhere to traffic rules and be careful when driving a vehicle. Do not drive while in the influence of alcoholic beverages.
- Check the depth of the river or pond before jumping in.
When meeting others who have an accident, prevent or reduce the risk of spinal cord injury to the neck or back by:
- Immediately contact the paramedics and do not move or move the victim before the paramedics arrive at the location.
- Place a thick towel on either side of the neck, or hold your neck and head, and ask the victim not to move until the paramedics arrive.
- Perform the first aid needed to stop the bleeding without moving the neck and head.
Enrich yourself, family members, and others around about spinal cord injury information, treatment options, and other support. The more information that can be known about this disease can help ease the burden and depression that can arise.