A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Some injuries will allow almost complete recovery. Others will result in complete paralysis.
There are several types of treatment in the short term for a spinal cord injury. First, the spine in the area of the injured spinal cord is immobilized (held in place so it can’t move) to prevent further injury to the cord. For injuries to the neck, immobilizing the spine may include placing the head in a “halo” (a device that prevents the head from moving). For spinal cord injuries in the back, casts, braces and straps may be temporarily used to keep the back from moving.
To reduce swelling in the spinal cord caused by injury, steroid medication is usually given during the first 24 hours following injury. Other medical treatment is often necessary, depending on complications that may develop.
Spinal injury is a devastating event that occurs suddenly and whose consequences range from minimal symptomatic pain to a tragic quadriplegia (total paralysis of all four limbs). The key element in management is prevention of secondary neurological damage occurring during transportation, so whenever a family physician sees a patient with suspected spinal injury the first thing to be done is immobilize the spine which is done with cervical collar and belts for thoracic and lumbar spine.
Treatment:
1. At the site of accident / clinic of the family physician :mainly deals with immobilization & proper transportation to the hospital.
2. In the hospital: Resuscitaion, haemodynamic stabilization, basic corrective surgery (if required), physiotherapy.
3. Surgeries: basic aims of surgery are decompression of the neural elements, reduction of malalignment and restoration of spinal stability.
a. Anterior /posterior
b. Decompression / stabilization
Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities. Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support.
Cell therapy, in particular, stem cell implantation has become a feasible therapy for spinal cord injury. Embryonic stem cells and fetal stem cells are the forefathers of the field of stem cell therapy. Extraction ,separation & processing of specific populations of adult stem cells in the laboratories has evolved such that they can be converted to various types of specialized cells (eg.neurons, liver cells, heart cells). Thus, adult stem cells will transcend ethical concerns, technical difficulties, and probably immunorejection.
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