What is Spinal Cord Injury
A spinal cord injury (SCI) is an injury to the spinal cord resulting in a
change, either temporary or permanent, in the cord's normal motor, sensory, or
autonomic function. Common causes of damage are trauma The spinal cord does not
have to be severed in order for a loss of function to occur. Depending on where
the spinal cord and nerve roots are damaged, the symptoms can vary widely, from
pain to paralysis to incontinence. Spinal cord injuries are described at various
levels of "incomplete", which can vary from having no effect on the patient to a
"complete" injury which means a total loss of function.
Treatment of spinal cord injuries starts with restraining the spine and
controlling inflammation to prevent further damage. The actual treatment can
vary widely depending on the location and extent of the injury. In many cases,
spinal cord injuries require substantial physical therapy and rehabilitation,
especially if the patient's injury interferes with activities of daily life.
Research into treatments for spinal cord injuries includes controlled
hypothermia and stem cells, though many treatments have not been studied
thoroughly and very little new research has been implemented in standard
care.
Signs and symptoms Of Spinal Cord Injury
Signs recorded by a clinician and symptoms experienced by a patient will vary
depending on where the spine is injured and the extent of the injury. These are
all determined by the area of the body that the injured area of the spine
innervates. A section of skin innervated through a specific part of the spine is
called a dermatome, and spinal injury can cause pain, numbness, or a loss of
sensation in the relevant areas. A group of muscles innervated through a
specific part of the spine is called a myotome, and injury to the spine can
cause problems with voluntary motor control. The muscles may contract
uncontrollably, become weak, or be completely paralysed. The loss of muscle
function can have additional effects if the muscle is not used, including
atrophy of the muscle and bone degeneration.
A severe injury may also cause problems in parts of the spine below the
injured area. In a "complete" spinal injury, all functions below the injured
area are lost. An "incomplete" spinal cord injury involves preservation of motor
or sensory function below the level of injury in the spinal cord.If the patient
has the ability to contract the anal sphincter voluntarily or to feel a pinprick
or touch around the anus, the injury is considered to be incomplete. The nerves
in this area are connected to the very lowest region of the spine, the sacral
region, and retaining sensation and function in these parts of the body
indicates that the spinal cord is only partially damaged. This includes a
phenomenon known as sacral sparing which involves the preservation of cutaneous
sensation in the sacral dermatomes, even though sensation is impaired in the
thoracic and lumbar dermatomes below the level of the lesion.[9] Sacral sparing
may also include the preservation of motor function (voluntary external anal
sphincter contraction) in the lowest sacral segments.[8]Sacral sparing has been
attributed to the fact that the sacral spinal pathways are not as likely as the
other spinal pathways to become compressed after injury. The sparing of the
sacral spinal pathways can be attributed to the lamination of fibers within the
spinal cord.
A complete injury frequently means that the patient has little hope of
functional recovery. The relative incidence of incomplete injuries compared to
complete spinal cord injury has improved over the past half century, due mainly
to the emphasis on faster and better initial care and stabilization of spinal
cord injury patients. Most patients with incomplete injuries recover at least
some function.
Determining the exact "level" of injury is critical in making accurate
predictions about the specific parts of the body that may be affected by
paralysis and loss of function. The level is assigned according to the location
of the injury by the vertebra of the spinal column closest to the injury on the
spinal cord.
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