Back Injury : Spinal Cord Injury
This represents an emergency requiring IMMEDIATE medical attention. Spinal cord injury occurs almost exclusively as the result of serious back injuries where significant force has been applied to the spinal column. In our society, motor vehicle accidents, falls, gunshot wounds, and industrial accidents account for the majority of these injuries.
The spinal cord is protected by bony structure known as vertebrae. The vertebrae are "stacked" in a column and stabilized by fibrous strands called ligaments. The muscles also serve as a support structure, protecting the spinal column from force. Spinal cord injury can occur whenever torsion placed on the cord itself. This often appears fractures of the vertebra or in major ligament disruptions, causing abnormal motion of the vertebrae in relation to one another.
Common symptoms of spinal cord injury include back pain at the point of the injury, with neurologic symptoms occurring below that particular area (leg numbness, weakness or tingling to the lower extremities).
Evaluation will include: examination for neurologic deficit. Spine x-rays will be taken to identify the possibility of fractures or malalignment of the vertebrae. Magnetic resonance scanning can aid in identifying areas of cord injury.
Hospitalization is mandatory and management by a Neurosurgeon is necessary. Prognosis can be quite variable and is based on the extent of cord damage.
Accurately predicting the extent of the injuries long-term disabling effects can be difficult. Rehabilitation (physical and occupational therapy) play a major role in the outcome.
Spinal cord injuries resulting in paralysis (inability to move lower extremities) require constant care. Bedsores, bladder and bowel dysfunction, and infections (bladder and respiratory) are common extenuating circumstances. Treating depression is also a difficult aspect in the management of these patients.
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