Recovery from acute spinal cord injury

 

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Spinal cord injury is the damage that occurs anywhere in the spinal cord or nerves at the end of spinal cord. The injury is most severe and is termed as acute spinal cord injury when it occurs in the cervical region and results in quadriplegia or paralysis which affects arms and legs. The injury in spinal cord may be complete or incomplete and may occur in cervical, thoracic, lumbar or sacral region.

Acute spinal cord injury occurs due to falls, accidents, sports or driving injuries, violence, infections or birth injuries. The disorder is diagnosed through blood tests, X rays, CT scan and MRI and requires immediate medical attention.

X rays decipher spinal cord problems, tumours, fractures while CT scan throw light precisely on abnormalities in bones and discs through cross-sectional images. MRI employs magnetic field and radio waves to spot herniated discs, blood clots and other issues that cause spinal cord compression.

Though acute spinal cord injury may not be reversed, treatments promote nerve cell regeneration or improve function of remaining nerves after the injury. The treatment also tries to prevent further injury when patients return to routine life.

Immediate medical treatment is required to minimize head and neck trauma after which secondary problems like muscle contractures, pressure ulcers, bowel and bladder issues and respiratory infections must be averted.

Treatment for acute spinal cord injury depends upon age and medical history of the patient, extent and type of spinal cord injury, response to initial treatment and patient’s preference. Recovery depends upon severity of the injury and while few recover in the first six months others take one to two years to recover.

Besides damage of independence and physical function, recovery includes facing other complications such as neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, autonomic dysreflexia and other depression disorders are confronted after acute spinal cord injury occurs.

Rehabilitation team including physical therapist, occupational therapist, nurse, psychologist, dietician works with the patient for recovering from acute spinal cord injury. During early stages of recovery process therapists focus on maintenance and improvement of muscle strength, redevelopment of motor skills and adaption to routine life tasks.

 Recovery from acute spinal cord injury includes stages such as reduction of swelling, recovery from surgery, regaining sensation and movement below the site of injury, using assistive devices like wheel chairs and prostheses, practicing new ways to do routine tasks and strengthening the body.

Psychological recovery from acute spinal cord injury is as important as physical recovery. Developing an attitude is important since many survivors of spinal cord injury suffer from anxiety, depression and other psychological issues.

Spinal cord injury can affect respiratory system especially when the cervical cord in injured. Intense use of respiratory aids can minimize risks of pneumonia, bronchial mucous plugging and respiratory failure. Muscle functions can be enhanced so that alveolar ventilation is maintained in the recovery of acute spinal cord injury.

For those whose lung function is damaged, non-invasive assisted ventilation is performed for rehabilitation period or for longer periods.