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Management of Traumatic Spinal Cord Injuries

A traumatic spinal cord injury can cause damage to nerves at the end of the spine or any part of the spinal cord. Trauma can be caused by an unexpected blow to the spine or a cut in the back. An SCI often causes permanent loss of strength, sensation, and function below the site of the lesion. Recovery and assistive gadgets assist patients with spinal cord injuries to live productive and independent lives.

How To Recognize Spinal Cord Trauma?

Suppose a patient has a traumatic spinal cord injury if they show the following symptoms:

  • Signs of head injury
  • Change in the level of awareness of the person
  • A patient complains of severe pain in his neck or back
  • There has been a strong impact on the back or head.
  • Person experiences weakness, numbness, or paralysis of their legs, bladder, or bowels

How To Provide First Aid For Spinal Injury?

The management of trauma starts before reaching the hospital. If you find a person has an injured neck or back, do not move or twist them. If you displace the affected person,  it may result in permanent paralysis and other serious complications. Provide the following first aid that is possible without shaking the person’s head or neck:

  • Remain the person still
  • Place towels or clothes wrapped around both sides of the neck.
  • If the person shows no signs of communication or breathing, start CPR, but do not turn the head back to open the airway.
  • If the person does not have a pulse, start chest compressions.
  • If he’s wearing a helmet, drop it.
  • If the person is vomiting, turn him on the side with the help of another person who will keep the spine of the sufferer straight. 
  • Seek medical help. Call an ambulance

Preliminary Testing And Diagnosis

When you arrive at the hospital, your doctor will carefully observe, examine and diagnose the patient to avoid spinal cord injury. He will also examine all the organs and senses in terms of movement, function by talking to the patient.

However, if the person has neck pain, fainting, or signs of weakness or nerve injury, emergency diagnostic tests may be needed. The common test prescribed by the doctors at Eva hospital for orthopedics are: 

X-rays: According to Dr. Tanveer Bhutani, X-rays are the first test we do for spinal trauma. X-rays can show vertebral problems, tumors, fractures, or degenerative abnormalities in the spine.

CT Scan or computerized tomography. A CT scan can provide a more detailed view of the abnormalities seen in the X-ray. This provides a cross-sectional view that outlines bone, disc, and other problems.

MRI or Magnetic resonance imaging. MRI provides computer-generated images. This is very useful in identifying herniated discs, blood clots, or other tissues that may be compressing the spine. 

A few days after the swelling subsides, Dr. Bhutani performs a detailed clinical examination to determine the level and completeness of your condition. It mainly involves testing muscle strength and the ability to feel light touch and prick sensations.

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Treatment

Traumatic SCI treatment mainly consists of stabilization, evaluation, and imaging. About 1/4th of the injuries deteriorate during the correction, transportation, or handling. Spinal stabilization is a priority. Extensive treatment includes: –

Surgical Treatment

As per Dr. Tanveer Bhutani, “ Sometimes, we may have to take a patient to the operation theater immediately. It is used for patients with incomplete SCI or who have progressive neurological deterioration. Even when damage to the spinal cord cannot be repaired with surgery, it is necessary to stabilize the injury and prevent further damage. The course is decided after the test.

Non-surgical Management

Whether to operate or not is relevant. The health of a patient, survival of a limb, and medical history are the main considerations. Non-surgical treatment is less beneficial in cases of neurological deficits but may be beneficial for a stable spine. However, increased immobility can increase the risk of bedsores, deep vein thrombosis, and pneumonia.

Rehabilitation

The rehabilitation team mainly consists of a physical therapist, a psychologist, and a dietitian. Patients are made aware of the consequences of spinal cord injury and further prevention. You are advised to rebuild and enhance your quality of life.

Conclusion 

Managing patients with severe spinal cord injuries may be difficult. It is important to handle and immobilize patients immediately after injury to protect them from seriousness. The main role of surgery is to prevent further neurological degeneration through decompression while stabilization reduces the complications associated with instability and speeds up rehabilitation.

About The Author

Tanveer Bhutani
Eva Hospital encompasses various modern orthopedic practices pioneered by the prominent orthopedic surgeon in Ludhiana “Dr. Tanveer Singh Bhutani”.

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