Spinal cords Injuries and Treatments

It acts as an intermediary between the brain and other body parts as it carries the nerves that send messages to and from the brain. Other than being part of the central nervous system, it is also a center for knee reflexes. The spinal cord is made up of three tissue layers commonly known as the meninges that surround it. Both the spinal cord and the meninges are surrounded by the vertebral column that protects it from any harm as it is fragile, in the same way that the skull protects the brain. The cartilage disks act as cushions that separate one vertebrae from another and also enhances the flexibility of the spine. Cauda equina are a bundle of nerves that extend over the spinal cord as it ends three quarter way of the spine.

This bundle of nerves looks like a horse’s tail and function to carry nerve signals to and from the feet (Goldman). Figure 1: Spinal Cord Structure (Goldman) The Spine and the Brain The brain is as fragile as the spinal cord. It is soft, spongy consisting of the several nerve cells as well as supportive tissue. It comprises three major parts, cerebellum, cerebrum and the brain stem, which work together but each with distinct functions. This fluid flows through the ventricles and the hollow spaces (subarachnoid space) in the brain with the aim of bringing nutrients from the blood to the brain and remove wastes from the brain (Harrison). The spinal cord runs down from the brain and has nerves that connect the brain and the other parts of the body.

However, some nerves directly link the body with other body parts, such as the ears, eyes and other parts of the head. These nerve networks carry information to and from the brain and the other parts of the body. Both the brain and the spinal cord are protected by three layers of membranes, that is meninges, namely, the dura mater which is the thickest outermost layer, the arachnoid layer which is thin and in the middle as well as the pia matter that is the innermost thin layer. These cases have become so common today. For instance, in the United States, about 12,000 cases of spinal cord injuries are reported, especially among the white males (Acikgoz, pp. Spinal cord injuries can either be complete or incomplete.

Complete spinal injuries occur when the sensation and functioning of the muscles is completely lost in the parts where the cord is injured and thus the body parts whose nerves are affected no longer work. On the other hand, incomplete injuries occur when despite the injury, some function still exists below the level of the spinal cord injury. Failure of this blood supply to the spinal cord can result when a blood vessel is compressed, balloons (aneurysm) or there is a constant and significant drop in the blood pressure (Chhabra & Arora, pp. Symptoms of Spinal Cord Injury The symptoms range from mild to severe depending on where the spinal cord is injured and whether the injury is complete or incomplete. If the injury is complete, the sensation and functioning of the muscles is completely lost in the parts where the cord is injured and thus the body parts whose nerves are affected no longer work.

If it is incomplete some function still exists below the level of the spinal cord injury. In most cases, spinal cord injuries are characterized with weakness or complete loss of the function of muscles leading to the loss of feeling below the level of injury, little or no control of the movement of the bowel and bladder and even the loss of the usual sexual functioning. This patient normally requires to be assisted at all times (24 hour personal assistance) with their daily activities including eating, clothing, taking a bath and even going in and out of the bed. For assistance, such patients could use special controls on a powered wheelchair to help them move around on their own (Hughes, pp. Low Cervical Nerves (C5 - C8) Injuries These injuries affect the nerves that are responsible for controlling the arms and hands.

This case is not severe as the person is capable of breathing on their own and even speak normally. If the injury is on C5 nerves, the patient is able to raise their arms and even bend their elbows. They can only perform simple daily living activities on their own but need assistance with the difficult ones. They can also drive a vehicle if it is adapted. Such patients can control their bowel or bladder movement to a lesser extent but, with the help of some special equipment, can manage on their own. Injuries in the C8 nerves, that control the movement of the hands, can perform the simple activities requiring help only in the difficult tasks. They can also grasp things and release them using their arms and can drive an adapted car.

They can use the manual wheelchair to move from place to place and are capable of driving a car if modified. Such patients can control their bowel or bladder movement to a lesser extent but, with the help of some special equipment, can manage on their own (Hughes, pp. Lumbar Nerves Injuries (L1 - L5) These injuries generally lead to the paralysis of both the hips and legs. The patients are able to control their bowel or bladder movement to a lesser extent but, with the help of some special equipment, can manage on their own. These patients are able to walk with braces or use a wheelchair which largely depends on the strength in their legs (Hughes, pp. It is mainly used to show further details of the injury as seen on the X-ray.

It uses the computer to give cross-sectional images showing problems on the bone, disk and other parts of the spine. Magnetic resonance imaging (MRI) This test makes use of a very strong magnetic field and radio waves to give out images generated from the computer. It closely looks at the spinal cord trying to identify if the disks are herniated, there are blood clots or if there are some objects pressing the cord. Following the subsiding of the swelling, a more detailed neurological examination can be done to find out how complete the injury is. The emergency medical personnel first make sure the spine is immobilized gently and as quickly as possible. Once the patient has been transported to the hospital, the doctors try to maintain the ability of breathing of these individuals, prevent shock and still ensure the patient’s spine is not moving.

In extreme situations, they also try to ensure that stool and urine are not retained, there is no respiratory or cardiovascular function difficulty and no formation of blood clots in the deep veins. Usually, the patients are admitted at the Intensive Care Unit to get treatment. These patients are taken care of by medical staff with the expertise in spinal cord injuries. The time one stays in the hospital depends on their state of medical health and the kind of injury. Once the condition stabilizes, the patient can be transferred into a rehabilitation center (Dickson, pp. Rehabilitation Once in the rehab, the team members of that rehab start helping the patient in their early days of recovery. The members of this team include, a nurse, psychologist, recreation therapist, physical therapist, occupational therapist, a social worker, dietitian and a psychiatrist or doctor specialized in spinal cord injuries.

At first, the therapists try to put emphasis on how to maintain and strengthen the function of the muscles, redevelopment of the fine motor skills and how to adopt to the day to day activities (Rice, et. New technologies These devices help patients with such injuries become independent and mobile. a) Modern wheelchairs: these wheelchairs have been improved and are light in weight to help the patients move more comfortably whenever need be, making them quite independent. In some cases, the wheelchair could use electricity. Some can even go up stairs, move through rough grounds and raise the patient to a higher level to get to high places without needing assistance (Bedbrook, pp. b) Computer adaptations. Prognosis and recovery It is not possible to get prognosis immediately but in case recovery takes place, it is usually within a period of a week to six months.