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Spinal Cord Injury: Causes, Diagnosis and Treatment Options

Introduction to Spinal Cord Injury

Understanding Spinal Cord Injuries

The spinal cord is a soft, fluid-filled sac that is encased within the bones of the spine and running from the base of the brain to the middle of the back. It contains nerves, blood vessels and cerebrospinal fluid. These nerves transmit signals from the brain to the rest of the body and vice versa.

Causes of Spinal Cord Injury

An injury to this fragile structure is life-threatening and should be treated as a medical emergency. The most common cause of injury is through traumatic injury. Other non-traumatic causes are epidural haematomas (blood clots), spinal tumours/metastases, and epidural abscesses.

Diagnosing Spinal Cord Injuries

Signs and Symptoms

The main clinical signs of a spinal cord compression are paralysis (constant weakness) of the arms and/or legs, loss of feeling below the site of injury, loss of bladder and/or bowel control, breathing difficulties, low blood pressure, and muscle spasms.

Diagnostic Techniques

The severity of the injury can be assessed as a complete or an incomplete paralysis. CT and MRI scans are the best radiological assessment tools. CT will help to detect fractures of the spinal column; an MRI detects soft tissue injury including ligament tear, disc displacement, tissue damage, and intraspinal haemorrhage. In the case of tumours and abscesses, an imaging of the entire spinal column with an injected dye is necessary. X-rays may also be used.

Treatment Options for Spinal Cord Injuries

Traumatic Spinal Compression

Surgery, when safe enough to proceed within 24 hours, is the primary therapy. This involves removing any pressure off the spinal cord, correction of the bone alignment, stabilisation of the spine with screws, rods or plates, and fusion of the vertebral bones to promote better long-term stability.

Spinal Tumours

Surgery followed by radiotherapy is the current standard treatment. Surgery involves removing the tumour with or without fixation techniques (depending on spinal stability). Radiotherapy is done once the wounds have healed to slow down tumour growth and steroid treatment has been shown to bring about an acute relief in nerve-related symptoms.

Spinal Abscesses and Epidural Haematomas

Surgery is required to remove the abscess or the haematoma. Antibiotics are administered postoperatively for any abscess surgery.

Prognosis and Rehabilitation for Spinal Cord Injury Patients

Factors Affecting Recovery

Recovery after spinal cord compression depends on how severe the problem is. Heart and breathing complications also tend to affect patients badly. Prompt surgery and postoperative rehabilitation bring about the best results.

Future Treatments and Support

Current research is focusing on neural prostheses and stem cell therapy in traumatic spinal cord injuries. These rehabilitation treatments, however, are experimental. Specialised rehabilitation centres that provide physical and occupational therapy are important. Spinal cord injuries can also have devastating psychological and psychosocial effects. Psychological and psychiatric therapies are usually needed. Support groups are a very positive influence for patients living with spinal cord injuries.

EUROSPINE is a society of spine specialists of various disciplines with a large knowledge of spine pathologies. All well-known and accepted treatment modalities for spine pathologies are represented by the members of the society. However, the Society cannot accept any responsibility for the use of the information provided; the user and their health care professionals must retain responsibility for their health care management.

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