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Spinal cord injury (SCI) |
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Spinal cord injury (SCI)
Spinal Cord Injury (SCI) is damage to the spinal cord that results in a loss of function such as mobility or feeling. A diagnosis of spinal cord injury can be devastating. Accidents - motor vehicle accidents, falls and sports injuries - and acts of violence cause most injuries to the spinal cord. The injury interferes with your brain's ability to communicate through your nervous system with other parts of your body. When to seek medical advice Spinal cord injury isn't always obvious. Numbness or paralysis may result immediately after a spinal cord injury or gradually as bleeding or swelling occurs in or around the spinal cord. In either case, the time between injury and treatment is a critical factor that can determine the extent of complications and the level of recovery. Anyone who has experienced significant trauma to the head or neck needs immediate medical evaluation for the possibility of spinal cord injury. In fact, it's safest to assume that trauma victims have an unstable spine fracture until proved otherwise. If you suspect a back or neck injury, don't move the injured person. Permanent paralysis and other serious complications may result. Take these steps once you suspect someone has a spinal injury:
Screening and diagnosis Paramedics and emergency workers are trained to treat people who have suffered a traumatic head or neck injury as if they have a spinal cord injury or an unstable spinal column, until a thorough screening and diagnosis can be completed. A key step in the initial treatment is immobilizing the spine. Immobilizing the spine can prevent injury to the spine or prevent worsening of any injury that is already present. For this reason, emergency personnel receive training in handling an injured person without moving the neck and back. They use rigid collars around the injured person's neck and place the injured person on a rigid board, until a complete evaluation can take place. In the emergency room, a doctor may be able to rule out spinal cord injury by carefully inspecting an injured person, testing for sensory function and movement, and asking some questions about the accident. But if the injured person complains of neck pain, isn't fully awake, or has obvious signs of weakness or neurologic injury, emergency diagnostic tests may be needed. These tests may include:
If your doctor suspects a spinal cord injury, he or she may prescribe traction to immobilize your spine, as well as high doses of the corticosteroid drug methylprednisolone (Medrol). This drug significantly improves neurologic functioning by reducing nerve damage and decreasing inflammation — if given within eight hours of injury. Diagnosis doesn't stop there, though. About three days after the injury, your doctor will conduct a neurologic exam to determine the severity of the injury and predict the likely extent of recovery. This may involve more X-rays, MRIs or more advanced imaging techniques. It's often impossible for your doctor to make a precise prognosis right away. Recovery typically starts between a week and six months after injury if it occurs, with the majority of recovery taking place within one year. Doctors generally regard any impairment remaining after 12 to 24 months as likely to be permanent.
Spinal cord injury
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