SPINAL CORD INJURY

The spinal cord is a collection of nerves that travels

from the bottom of the brain down your back. There are
31 pairs of nerves that leave the spinal cord and go to
arms, legs, chest and abdomen. These nerves allow
your brain to give commands to your muscles and
cause movements of your arms and legs.

 A spinal cord injury occurs when there is damage to the

spinal cord either from trauma, loss of its normal blood
supply, or compression from tumor or infection
Spinal cord trauma is damage to the spinal cord. It may
result from direct injury to the cord itself or indirectly
from disease of the surrounding bones, tissues, or blood
vessels.

Incidence
There are approximately 10,000 new cases of spinal
cord injury each year in the United States. They are
most common in white males. Specifically, 80% of
spinal cord injuries occur in males, and 2/3 occur in
whites. Most injuries occur in patients 16-30 years of
age.

Etiologi

Spinal cord injuries are described as either complete

or incomplete.
In acomplete spinal cord injurythere is complete
loss of sensation and muscle function in the body below
the level of the injury.
In anincomplete spinal cord injurythere is some
remaining function below the level of the injury. In most
cases both sides of the body are affected equally.

Cross section images of the spinal cord

classic syndrome of the spinal cord. a) central cord

syndrome, b) anterior cord syndrome, c) brown
squard cord syndrome, d)posterior cord syndrome

The frequency of spinal cord injury

mechanism of injury flexion and dislocation c5-c6

injury antroflextion mechanism

compression injury mechanism

injury hyperextension mechanism

primary and secondary injury of spinal cord injury

Treatment
A spinal cordinjury is a medical emergency that needs to be
treated right away. The time between the injury and
treatment can affect the outcome.
Corticosteroids, such as dexamethasone , are used to reduce
swelling that may damage the spinal cord.
If spinal cordpressure is caused by agrowth that can be
removed or reduced before spinal nerves are completely
destroyed, paralysismay improve. Ideally,
corticosteroids should begin as soon as possible after the
injury.

 Bed rest may be needed to allow the bones of the spine

to heal.
Spinal tractionmay be recommended. This can help
keep the spine from moving.

 The health care team will also provide information on muscle

spasme, care of the skin, and bowel and bladder dysfunction.skin will
be protected against pressure sores.
You will probably needphysical therapy, occupational therapy, and
other rehabilitation therapies after the injury has healed.
Rehabilitation will help cope with thedisability from spinal cord injury.
Muscle spasticity can be relieved with medications taken by mouth or
injected into the spinal canal. Botox injections into the muscles may
also be helpful.
Painkillers (analgesics), muscle relaxers, and physical therapy are
used to help control pain.

Surgery may be needed to:

Remove fluid or tissue that presses on the spinal cord
(decompression laminectomy)
Remove bone fragments, disk fragments, or foreign
objects
Fuse broken spinal bones or place spinal braces.

Complications
These complications include:
urinary tract infectionsorurinary incontinence(inability to control the
flow of urine),
bowel incontinence(inability to control bowel movements),
pressure sores,
infections in the lungs (pneumonia),
blood clots,
muscle spasms,
chronic pain, and
depression