Injured Spinal Cord

There are just A few organizations that take care of these persons

GURDEEP SINGH

Spinal cord injury is a low incidence but a very high cost disability. Rehabilitating such individuals and to give them a life of dignity is a binding duty on us, so that they don’t feel like children of a lesser God.
To rehabilitate such persons is an uphill task and it needs to understand their requirements especially in health care, due to complications associated with spinal cord damage.
In the Kashmir valley every year there is rise in this type of disability due to RTA (Road Traffic Accidents), fall from height, and other things related to conflict; bullet and blasts injuries.
There are just few organizations that take care of these persons by providing healthcare and medical aid; only a tip of iceberg. Among them is Help Poor voluntary Organization (HPVT) and Voluntary Medicare Society (VMS), Bemina.

Spinal Cord Injury
Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from damage to surrounding bones, tissues, or blood vessels.

Causes, Incidence, and Risk factors
Spinal cord trauma can be caused by any number of injuries to the spine. They can result from motor vehicle accidents, falls, sports injuries (particularly diving into shallow water), industrial accidents, gunshot wounds, assault, and other causes.
A minor injury can cause spinal cord trauma if the spine is weakened (such as from rheumatoid arthritis or osteoporosis) or if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis) due to the normal aging process.
Direct injury, such as cuts, can occur to the spinal cord, particularly if the bones or the disks have been damaged. Fragments of bone (for example, from broken vertebrae, which are the spine bones) or fragments of metal (such as from a traffic accident or gunshot) can cut or damage the spinal cord.
Direct damage can also occur if the spinal cord is pulled, pressed sideways, or compressed. This may occur if the head, neck, or back are twisted abnormally during an accident or injury.
Bleeding, fluid accumulation, and swelling can occur inside the spinal cord or outside the spinal cord (but within the spinal canal). The accumulation of blood or fluid can compress the spinal cord and damage it.
Most spinal cord trauma happens to young, healthy individuals. Men aged 15 - 35 are most commonly affected. The death rate tends to be higher in young children with spinal injuries.
Risk factors include participating in risky physical activities, not wearing protective gear during work or play, or diving into shallow water.
Older people with weakened spines (from osteoporosis) may be more likely to have a spinal cord injury. Patients who have other medical problems that make them prone to falling from weakness or clumsiness (from stroke, for example) may also be more susceptible.

Signs and Tests
Spinal cord injury is a medical emergency requiring immediate attention. The health care provider will perform a physical exam, including a neurological exam. This will help identify the exact location of the injury, if it is not already known. Some of the person's reflexes may be abnormal or absent. Once swelling goes down, some reflexes may slowly recover.
The following tests may be ordered:
• A CT scan or MRI of the spine may show the location and extent of the damage and reveal problems such as blood clots (hematomas).
• Myelogram (an x-ray of the spine after injection of dye) may be necessary in rare cases.
• Somatosensory evoked potential (SSEP) testing or magnetic stimulation may show if nerve signals can pass through the spinal cord.
• Spine x-rays may show fracture or damage to the bones of the spine.

Treatment
A spinal cord trauma is a medical emergency requiring immediate treatment to reduce the long-term effects. The time between the injury and treatment is a critical factor affecting the eventual outcome.
Corticosteroids, such as dexamethasone or methylprednisolone, are used to reduce swelling that may damage the spinal cord. If spinal cord compression is caused by a mass (such as a hematoma or bony fragment) that can be removed or reduced before your spinal nerves are completely destroyed, paralysis may improve. Ideally, corticosteroids should begin as soon as possible after the injury.
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
People living at home with spinal cord injury should do the following to prevent complications:
• Daily pulmonary care, for those who need it.
• Follow all instructions regarding bladder care to avoid infections and damage to the kidneys.
• Follow all instructions regarding routine wound care to avoid pressure sores.
• Keep immunizations up to date.
• Maintain routine health visits with their doctor.
So keeping such major health problems into considerations, it needs a lot of funding to meet the expenses of such persons to minimize the damage. And give them a chance to survive!

Author is himself a paraplegic due to SCI and is a volunteer with HPVT; works as a coordinater to provide  medical consultation and medicines beside personal hygiene related items, after getting the affected registered with HPVT, free of cost. Reach him out at…….

Lastupdate on : Tue, 8 Jan 2013 21:30:00 Makkah time
Lastupdate on : Tue, 8 Jan 2013 18:30:00 GMT
Lastupdate on : Wed, 9 Jan 2013 00:00:00 IST




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