Spinal cord injury is a condition that causes damage to the nerves located in the spine. Spinal cord injuries are commonly caused by car accidents, sports injuries, or physical abuse.
The spinal cord is a continuation of the brain that extends from the neck to the tailbone. If this nerve is damaged, it will disrupt several body functions, such as loss of the ability to move or feel something.
Spinal nerve injuries must be treated immediately. If treatment is not done immediately, the patient may need a longer recovery period. In addition, the possibility of worsening conditions or the emergence of complications will also be greater.
Causes of Spinal Cord Injury
Spinal nerve damage can be triggered by traumatic (primary) or non-traumatic (secondary) causes experienced by the spine. Some examples of causes include:
- Motor Vehicle Accidents. Accidents are the most common cause of this condition.
- Increasing Age. Especially those over 65 years old, are at risk of experiencing spinal cord injury due to falls.
- Sports or Recreational Injuries. Some athletic activities such as shallow water diving, horse riding, skiing, skateboarding, etc. carry the risk of spinal cord injury when falling.
- Violence. Injuries can range from gunshot wounds and stab wounds that cut or injure the spinal cord.
- Other Diseases. This condition can be triggered by non-traumatic injuries, such as from cancer, arthritis, inflammation, osteoporosis, bone or joint disorders, and infections or decreased number of spinal discs.
- Alcohol. Excessive alcohol use is a common cause of spinal cord injury.
Risk factors for spinal cord injury
There are several risk factors that can increase a person's risk of experiencing this disease, including:
- Gender because spinal cord injuries are more likely to occur in men.
- Age, because people aged 16-30 years or over 65 years are more susceptible to spinal cord injuries.
- Participating in high-risk activities such as jumping into shallow water or playing sports without proper protective gear can lead to spinal trauma.
- Other bone or joint diseases.
Spinal Cord Injury Symptoms
Spinal cord injuries can cause one or more of the following signs and symptoms:
- Loss of movement/paralysis
- Loss of the ability to feel heat, cold, and touch
- Loss of bowel or bladder control
- Excessive reflex activity or seizures
- Changes in sexual function, sexual sensitivity and fertility
- Pain or a stinging sensation caused by damage to nerve fibers in the spinal cord
- Difficulty breathing, coughing, or expelling mucus from the lungs
- Extreme back pain or pressure in the neck, head, or back
- Numbness, tingling, or loss of sensation in the hands, fingers, feet or toes
- Strange or bent neck or back position
When to see a doctor
Anyone who experiences a traumatic event to the head or neck, such as a blow or fall, needs immediate medical attention to check for spinal cord injury. In fact, it is safest to assume a spinal injury until proven otherwise because serious injuries are not always immediately apparent. If left undetected, the injury can become more severe. In addition, numbness or paralysis can occur gradually. The time between injury and treatment also determines the chances of recovery for spinal cord injury patients.
Spinal Cord Injury Diagnosis
The doctor will ask about the symptoms and complaints experienced, medical history, and medical procedures that the patient has undergone. In patients who have had an accident, the doctor will ask about the incident in detail, especially how the impact was experienced by the patient.
After that, the doctor will perform a physical examination and a neurological examination which includes examining muscle strength and the patient's ability to feel touch, vibration, or temperature.
The doctor will also perform several supporting examinations to see the condition of the patient's spine and spinal nerves. The following are examinations used in diagnosing spinal nerve injuries:
- X-ray Photo
X-rays are performed if there is suspicion that there has been damage to the spine after an accident, such as a spinal fracture. - CT scan
This test serves to show a better image of the spine than an X-ray. - MRI
MRI can help doctors see soft tissues, such as the spinal cord itself and the soft tissues around it. It can also detect a herniated nucleus pulposus or blood clots more accurately.
Spinal Cord Injury Treatment
In injuries caused by accidents, the patient needs to be fitted with a neck brace immediately after the accident. This is to prevent movement of the spine that can make the injury worse.
After that, the patient will be placed on a special stretcher to be taken to the emergency room. In critical conditions after an accident, the emergency room doctor will take action to maintain the patient's ability to breathe, prevent shock, and maintain spinal stability.
Once the patient is stable, the doctor will begin providing therapy to treat the spinal cord injury itself. Some of the efforts made by the doctor include:
- Traction installation
Patients may be given neck and back supports or special beds, so that their head, neck, or back do not move at all. This is done to prevent the patient's condition from getting worse and to return the spinal arrangement to its normal position. - Surgery
If necessary, the doctor will perform surgery to stabilize the position of the broken spine, remove bone fragments, foreign objects, or spinal cracks that press on the spinal nerves.
Patients will also receive supportive therapy, such as fluid and nutrient infusions, feeding tubes, and urinary catheters. In some cases, patients need a ventilator to be able to breathe properly.
Follow-up care
For both traumatic and non-traumatic patients, doctors will perform physiotherapy procedures after the patient's condition improves. However, the time it takes for a patient to undergo physiotherapy can vary. The greater the damage, the longer it will take.
During rehabilitation, the patient will be directed by the doctor to train muscle strength and restore mobility. If necessary, the doctor will provide medication to relieve pain.
Patients who have not recovered and are paralyzed are advised to use special support equipment.
The recovery period for spinal cord injuries usually lasts around 1 week to 6 months. However, in some cases, the time it takes for patients to recover and be able to move freely can reach 1–2 years.
Spinal Cord Injury Complications
Complications that can occur due to spinal cord injuries are generally caused by limitations in the body's muscles in moving, including:
- Muscle tissue shrinks (muscle atrophy)
- Weight gain due to very limited activity
- Injuries to the back or buttocks due to immobility
- Pneumonia due to suboptimal breathing movements
- Constipation or constipation
- Swelling of the legs
- Blood clots that can block blood vessels in the legs
Apart from that, there are also several other complications that can occur, namely:
- Muscle stiffness
- Urinary disorders
- Urinary tract infection
- Unstable blood pressure
- Neurogenic shock
- Sexual dysfunction
- Decreased fertility
- Depression
- Pain that doesn't go away in a certain part of the body
Prevention of Spinal Cord Injuries
Spinal cord injuries can occur when someone experiences a collision or falls. Therefore, it is very important to be careful in every action to avoid accidents.
If you see someone who has had an accident, prevent or reduce the risk of spinal cord injury to the neck or back by:
- Call paramedics immediately and do not move or move the victim before paramedics arrive on the scene.
- Place a thick towel on either side of the neck, or hold the neck and head, and ask the victim to remain still until paramedics arrive.
- Perform necessary first aid to stop bleeding without moving the neck and head.
Article written by dr. Lukas Galileo Malau, Sp. BS (Neurosurgery Specialist at EMC Cikarang Hospital).