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Posted Apr 17 2010 12:00am

           Spinal cord injury (SCI) is damage to the spinal cord as a result of a direct trauma to the spinal cord itself or as a result of indirect damage to the bones, soft tissues and vessels surrounding the spinal cord. Frequent causes of damage are trauma (car accident, gunshot, falls, etc.) or disease (polio, spina bifida, Friedreich’s Ataxia, etc.).  About ten thousand new spinal cord injuries occur each year in the United States.  About 250,000 people currently have this condition.  About 6 percent of those who suffer injury to the lower spine die within a year while approximately 40 percent of those who suffer injury to the upper spine die within a year.  Spinal cord injury can happen to anyone at any time of life.  The typical patient, however, is a man between the ages of 19 and 26.  Alcohol or drug abuse is involved in many of the accidents that result in spinal cord injuries.  This article explains treating and understanding a spinal cord injury.

          The spinal cord is the major bundle of nerves carrying nerve impulses to and from the brain to the rest of the body.  Rings of bone called vertebrae surround the spinal cord.  These bones constitute the spinal column (back bones).  Spinal cord damage results in a loss of function, such as mobility or feeling.  In most people who have spinal cord injury, the spinal cord is intact.  Spinal cord injury is not the same as back injury, which might result from causes such as pinched nerves or ruptured disks.  Even when a person sustains a break in a vertebra or vertebrae, there might not be any spinal cord injury if the spinal cord itself is not affected.  There are two kinds of spinal cord injury complete and incomplete.  In a complete injury, there is no function below the level of the injury.  There is no sensation or voluntary movement.  In an incomplete injury, there is some functioning below the level of the injury. 

          In general, the higher in the spinal column the injury occurs, the more dysfunction a person will experience.  The vertebra are named according to their location.  The eight vertebra in the neck are called the Cervical Vertebra.  The top vertebra is called C-1, the next is C-2, etc.  Cervical SCI’s usually cause loss of function in the arms and legs, resulting in quadriplegia. The twelve vertebra in the chest are called the Thoracic Vertebra.  The first thoracic vertebra, T-1, is the vertebra where the top rib attaches.  Injuries in the thoracic region usually affect the chest and the legs and result in paraplegia.  The vertebra in the lower back between the thoracic vertebra, where the ribs attach, and the pelvis (hip bone), are the Lumbar Vertebra.  The sacral vertebra run from the Pelvis to the end of the spinal column. Injuries to the five Lumbar vertebra (L-1 thru L-5) and similarly to the five Sacral Vertebra (S-1 thru S-5) generally result in some loss of functioning in the hips and legs.

          A spinal cord injury requires immediate treatment to avoid long-term effects.  The extent of spinal cord injury will be determined by neurological examinations, CT scan or MRI of the spine and spine X-rays.  Corticosteroid drugs such as dexamethasone or methylprednisolone are used to reduce swelling.  In some cases, surgery might be recommended.  Bed rest might be needed in order for the spine to heal.  After acute spinal cord injuries occur, physical therapy, occupational therapy and other rehabilitation interventions sometimes are required.  Careful nursing observations must be adhered to, as there can be several complications from spinal cord injuries.  The most common problems include blood clots, respiratory infections, sexual dysfunction, calcium deposits in the muscles and tendons, skin breakdown, fractures, pneumonia, spasticity and loss of bowel and bladder control.  

          There are currently no treatments that will make a spinal cord grow back to its normal condition.  One must be understanding and provide people with spinal cord injuries how to avoid complications and to make the best use of those bodily functions they still control.  Treating patients with a spinal cord injury often requires a variety of professional workers, including a neurologist (specialist in nerve disorders), psychiatrist or psychologist, physical therapist and occupational therapist.  Depending on the type of injury, a patient might also need the help of a respiratory therapist, speech-language specialist, nutritionist, and a special education teacher or recreation therapist.  Support groups also provide important information, advice, and emotional support for SCI patients.  Support groups are made up of other individuals who have the same medical problem.

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