Spinal Cord Injury
This week we will take a look in more detail to everything related to spinal cord injuries including what causes them, what types of injury there are and what treatment options are available. However, like in other posts, we will start off with a definition. Exactly, what is a spinal cord injury?
It is normally considered that a spinal cord injury took place when the spinal cord has been damaged as a result of a traumatic event or a disease, although 90% of all spinal cord injuries are caused by traumatic events that could have been avoided. According to the World Health Organization (WHO), between 250.000 and 500.000 people suffer from a spinal cord injury every year worldwide.
On the other hand, symptoms associated with a spinal cord injury will mostly depend on the severity of the injury and on its location on the spinal cord. Among the most common ones are the loss -complete or partial- of sensibility or the loss of motor control of the upper extremities, of the lower extremities or even, of the whole body. The more serious injuries can affect the bowel and bladder regulation, breathing, blood pressure or the cardiac rhythm. Furthermore, many of those who have suffered from a spinal cord injury will also be affected by chronic pain.
What Causes a Spinal Cord Injury?
As mentioned in the previous section, in the majority of situations, the main cause for spinal cord injuries was a traumatic event. In fact, the main cause for the majority of spinal cord injuries will normally be a traffic accident. Afterwards, the most common cause are accidental falls. These falls tend to occur fortuitously, while performing a high-risk activity (normally what is considered a extreme sport) or due to a work-related accident. On the other hand, another common cause that ends in a spinal cord injury is violence-related events. In this case, the spinal cord injury will occur as a result of a physical aggression due to a fight, an attack or a similar act. However, in most cases, the injuries caused by an act of violence are related to a bullet wound.
However, there is also a possibility that the brain injury occurs due to a health condition. In this way, different health conditions that can lead to a spinal cord injury, will also have similar effects to those described in previous sections. Some examples are poliomyelitis, spina bifida, primary or metastatic tumors that directly affect the spinal cord and Friedreich’s ataxia.
Types of Spinal Cord Injury
Just as with other neurological injuries, there are different types of spinal cord injuries. As a result, the type of injury will be determined by its level of severity and its location in the spinal cord.
In this way, if the spinal cord injury takes place at the cervical level, the resulting condition would be a tetraplegia. A tetraplegia is the loss or reduction in sensibility and/or motor control (voluntary movement) of the upper extremities (arms), lower extremities (legs) and all of the trunk.
However, if the spinal cord injury takes place at the thoracic and lumbar level, the corresponding condition would be a paraplegia. Aparaplegia will result in a lack of sensibility and/or a total or partial paralysis of the lower extremities (legs) and of the part of the trunk that is below the location where the injury took place.
Finally, a spinal cord injury at the spinal cord cone and the cauda equina level (lower part of the spinal cord) will affect sensibility and reduce voluntary movement but, normally, will not affect the ability to walk. However, the most common sequelae will be the loss of sphincter control and alterations in sexually-related aspects.
Spinal Cord Injury Rehabilitation
Finally, in this last section we will see what rehabilitation options are available for those that have suffered a spinal cord injury. Although there is no “cure” for this type of injury, it is possible to obtain functional improvements that can allow individuals to have a greater autonomy in their daily lives. Al igual que con otras lesiones neurológicas, el tipo de tratamiento y el pronóstico dependerán del tipo de lesión sufrida. Although there are no guarantees for a patient’s recovery, the type of injury will be determined by its severity and its location.
A rehabilitation treatment will be very useful to reduce the severity of an injury, to improve the motor control of any affected muscles and to gain functional skills that will provide patients with a greater autonomy and mobility. Moreover, it is highly recommended that the rehabilitation treatment received has a multidisciplinary nature. That is, that during the rehabilitation process physiatrists, physiotherapists, occupational therapists, speech and language therapists and nursing work as a team and in a coordinated manner. This type of complex injury requires a different approach that is not tries to recover loss functionality, but is also focused on learning the new skills required to adapt to the changing circumstances caused by the injury.