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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. Treatment Today, there's still no way to reverse damage to the spinal cord. But advances in recent years have improved the recovery of patients with a spinal cord injury and halved the amount of time survivors must spend in the hospital. Researchers are optimistically working on new treatments, including innovative prostheses and medications that may promote nerve cell regeneration or improve the function of the nerves that remain after a spinal cord injury. In the meantime, treatment focuses on preventing further injury and enabling people with a spinal cord injury to return to an active and productive life within the limits of their disability. This requires urgent emergency attention and ongoing care.
Emergency actions If you suffer a head or neck injury, you'll likely be treated by paramedics and emergency workers who will attend to three immediate concerns — maintaining your ability to breathe, keeping you from going into shock and immobilizing your neck to prevent further spinal cord damage. Emergency personnel typically immobilize the spine as gently and quickly as possible using a rigid neck collar and a rigid carrying board, which they'll use to transport you to the hospital. In the emergency room, doctors focus on maintaining your blood pressure, breathing and neck stabilization and avoiding possible complications, such as stool or urine retention, respiratory or cardiovascular difficulty, and formation of deep vein blood clots in the extremities. You may be sedated so that you don't move and cause more damage while undergoing diagnostic tests for spinal cord injury. If you do have a spinal cord injury, you'll usually be admitted to the intensive care unit for treatment. You may even be transferred to a regional spine injury center that has a team of neurosurgeons, orthopedic surgeons, spinal cord medicine specialists, psychologists, nurses, therapists and social workers with expertise in spinal cord injury. In the early stages of paraplegia or quadriplegia, your doctor will treat the injury or disease that caused the loss of function. Immediate treatment may include:
Ongoing care Rehabilitation. During your hospital stay, a rehabilitation team will work with you to improve your remaining muscle strength and to give you the greatest possible mobility and independence. Your team may include a physical therapist, occupational therapist, rehabilitation nurse, rehabilitation psychologist, social worker, nutritionist, and recreation therapist. During the initial stages of rehabilitation, therapists usually emphasize regaining leg and arm strength, redeveloping fine motor skills and learning adaptive techniques to accomplish day-to-day tasks. A program typically includes exercise, as well as training on the medical devices you'll need to assist you, such as a wheelchair or equipment that can make it easier to fasten buttons or dial a telephone. Therapy often begins in the hospital and continues for several weeks in a rehabilitation facility. As therapy continues, you and your family members will receive counseling and assistance on a wide range of topics, from dealing with urinary tract infections and skin care to modifying your home and car to accommodate your disability. Therapists will encourage you to resume your favorite hobbies, participate in athletic activities and return to the workplace, if possible. They'll even help determine what type of assistive equipment you'll need for these vocational and recreational activities and teach you how to use it. Medications. You may benefit from medications that manage the signs, symptoms and complications of spinal cord injury. These include medications to control pain and muscle spasticity, as well as medications that can improve bladder control, bowel control and sexual functioning. You may also need short-term medications from time to time, such as antibiotics for urinary tract infections. New technologies. Inventive medical devices can help people with a spinal cord injury become more independent and more mobile. Some apparatuses also may restore function. These include:
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