Today you can find out what a spinal cord injury is, how it is treated and what are the consequences of this injury. I would like to note right away that these injuries are very dangerous for human he alth and can permanently tie the patient to a wheelchair. Treatment and recovery is very long and is carried out in a stationary mode.
Contusion of the spine, or rather, the spinal cord, is also called a contusion. With this type of injury, the process of destruction of the substance of the spinal cord is observed, which can be partial or total. Also distinguishing features are hemorrhages, the presence of areas of ischemia, edema and necrosis.
Symptomatics
Let's make a reservation right away: any severe back injury is accompanied by spinal shock. What is this state? In this case, a person becomes completely immobilized, sensitivity disappears and the functioning of the pelvic organs is disrupted. Thus, the patient cannot independently control the process of bowel movement. In a state of spinal shock observed:
- pallor of the skin;
- low blood pressure;
- oppressed breathing;
- bradycardia.
Now no one can make an accurate diagnosis, it is necessary to wait until the nerve endings are restored. It is now that symptoms will begin to appear that will help locate the site of the injury and clarify its severity.
The entire human spinal column can be divided into the following sections:
- cervical;
- chest;
- lumbar;
- sacral;
- coccygeal.
According to statistics, the lumbar region suffers most often (43.2%), followed by the thoracic (41.4%), then the cervical (10.2%). We propose to analyze the symptoms of each of these departments in more detail.
Neck
When the spinal cord of the spine (the cervical region in this case) is injured, the following symptoms are observed:
- contusion;
- edema, the localization of which falls precisely on the cervical region;
- paralysis of the hands (it can be partial or complete);
- loss of cervical sensitivity;
- loss of mobility;
- visual impairment;
- hearing loss;
- possible memory loss;
- movements are not coordinated;
- pain and stiffness at the site of injury.
The victim must undergo radiation diagnostics, which shows the following:
- impaired impulse conduction;
- hemorrhage of blood vessels is observed.
If the bruise was severe enough, then you may face an irreversible consequence - crushing of soft tissue.
Breastdepartment
Please note that this is a sedentary part of the spinal column, which is limited by the mobile parts of the neck and lower back. Also, when considering the anatomical structure, one can notice that the thoracic region has a very narrow spinal canal, which is the decisive factor in possible complications in case of injury.
A bruise in this area is very difficult to diagnose, and the symptoms directly depend on the degree of damage. As a rule, symptoms are disguised as other disorders that are characteristic not only of this section of the spinal column, but also of other organs.
Manifestations:
- swelling;
- numbness of the tissue at the site of injury;
- pain in the heart;
- disorders of the gastrointestinal tract;
- urinary disorders;
- breathing disorders;
- hematomas.
Lumbar
Contusion of the spinal cord, which occurred as a result of injury to this part of the spine, can affect the functioning of many human organs.
If the injury is not severe, then the following manifestations can be observed:
- violation of the integrity of muscle tissue;
- numbness at the site of injury.
A severe bruise has very sad consequences that can lead to impaired mobility of the spine. Thus, the patient cannot stand, sit or remain still for a long time.
During rehabilitation, it is simply necessary to perform special exercises tolumbar spine, as inactivity can lead to poor blood circulation in the lower extremities and to atrophy of muscle tissue.
In addition to all of the above, swelling of the ankle or ankle may occur.
Reasons
Please note that our spinal cord has very good protection from all sides. Thus, it is not so easy to get injured in this organ. This becomes possible only with a strong mechanical impact on the human spinal column. Spinal cord injury can most often be obtained in three ways:
- accident (this is the most common cause, which can lead not only to a bruise, but also to other, more serious injuries; while the victim may not even drive a vehicle);
- wrong behavior in water;
- falling from a height.
Injuries in road accidents are possible in the following cases:
- hard braking;
- hit in the trunk;
- dramatic tilting of the head forward and then back (or vice versa).
Spinal cord injury from improper diving can be caused by muscle relaxation during free fall. Fall injuries are more common among children. I distinguish several types:
- falling from a human height;
- up to 1.5 meters;
- more than 1.5 meters.
In this case, landing on your feet can cause more significant damage, because in this case, the spinal column is fractured in several places at once. Besides,the cause may be a blow to the back. Pay attention to the fact that this blow can even be delivered by an explosive wave that can throw the victim a very long distance.
As a rule, spinal cord injuries lead to damage to the bone structure, nerve and vascular formations. At the same time, some factors are distinguished that provoke the death of nerve endings. These may be primary factors:
- pressure;
- straight backstab;
- gap;
- stretching.
Secondaries:
- hypoxia;
- violation of microcirculation;
- electrolyte imbalance.
Types of injury
All spinal cord injuries can be divided into two broad groups:
- open type (violated integrity of the skin);
- closed type (the integrity of the skin is not broken).
Possible damage to the spinal column:
- tear or sprain;
- fracture (types: compression, comminuted, explosive, marginal, horizontal, vertical);
- intervertebral disc injury;
- dislocation;
- subluxation;
- spondylolisthesis.
The last term is commonly understood as displacement of the vertebrae.
Spinal cord injuries include the following:
- concussion;
- squeezing;
- gap;
- spinal cord injury (contusion).
Possible Complications
Bruise means damageorgan, which occurred due to the impact of the spinal cord itself on the walls of the spinal canal. With this phenomenon, there is a violation of impulse conduction, and this has a bad effect on the overall functioning of the body. In the absence of qualified assistance, it is impossible to avoid consequences that directly depend on the severity of the lesion.
- Mild degree responds very well to treatment and does not pose a serious danger to the body. The patient is prescribed drugs that help restore blood circulation, it is necessary to undergo a rehabilitation course.
- Medium severity is more dangerous, because with such a bruise, the integrity of the tissue of the spinal cord is violated. If an infection enters, sepsis, the development of diseases of the urinary tract or bronchopneumonia are possible. Characteristic features of such injuries: hematomas, damage to nerve endings.
- Complete conduction failure leads to irreversible injuries (necrotic phenomena, increased arterial and intracranial pressure, which can cause a heart attack or stroke). Thromboembolism, development of articular contractures, vein thrombosis are also possible.
Emergency
The prognosis of spinal cord injury directly depends on the speed and quality of first aid. In this section you will find information on how to provide it, a sequence of actions that will not harm the injured person.
- First, lay the person on a flat and hard surface (better if it is a shield).
- Apply ice to the bruised area, this will help relieve swelling and partially anesthetize the damaged area.
- It is possible to introduce an anesthetic drug if necessary, but upon the arrival of an ambulance, it is imperative to report that the victim was taking. This is necessary, since the arrived specialist will first of all give him an intramuscular injection of Promedol.
- Before the ambulance arrives, it is necessary to monitor the pressure, breathing and pulse of the victim.
When medical workers arrive, they will definitely put in a catheter that will remove urine, inject the necessary drugs and take the patient to the hospital.
Treatment
When a patient is admitted to the hospital with suspected spinal injury, it is necessary to conduct a comprehensive examination, which includes the following procedures:
- examination by a neurologist, which will help to make an accurate diagnosis and recognize the severity of the lesion;
- x-ray of the damaged area, which allows you to find out if there is damage to the vertebrae;
- computed tomography;
- angiography;
- MRI (Magnetic Resonance Imaging);
- myelography, which allows to recognize pathological conditions.
Let's take a closer look at angiography - a procedure that allows you to determine the condition of blood vessels. This is necessary for the recognition of hemorrhages. In this case, temperature and pain dissociated sensory disturbances are observed. maybemanifestation of vegetative-trophic disorders with damage to the lateral horns. Segmental disorders, conduction disorders of sensitivity, pyramidal symptoms are observed, which can be explained by squeezing the lateral cords of the spinal cord.
There are two treatments, depending on the severity of the injury:
- drug (methylprednisolone, betamethasone, saline solutions, diuretics, magnesium sulfate);
- operational (performed only in case of severe injuries or squeezing of the organ).
Periods
Contusion of the spinal cord and other injuries of the spinal column go through three periods. Briefly about them below:
- Intermediate - about two months after damage. A distinctive feature is contracture in the joints.
- The duration of the late period is one year. All this time, the victim must be under the control of specialists who monitor the dynamics of the clinical picture.
- The residual period is characterized by residual manifestations of trauma. A distinctive feature is the beginning of the formation of new neurological functions.
Rehabilitation period
Whether the patient will walk after the injury can be found out on the second day after the spinal shock. In the absence of restoration of functions, we are already talking about irreversible consequences.
After all the research and treatment of spinal cord injury, it is necessary to move on to the rehabilitation process.
- Hirudotherapy, that is, treatment with leeches. This procedure has several beneficial effects at once: it helps to get rid of hematomas and thrombosis. There is also an analgesic and sedative effect due to the production of a special substance during the bite.
- Magnetotherapy has a beneficial effect on the restoration of nerve roots and improves the patency of impulses. In addition, the procedure helps to normalize blood supply.
- Therapeutic exercise. In this case, a set of exercises is selected based on the type of injury. For example, exercises for the lumbar spine help with an injury of the same department. The basis of this method of rehabilitation is the creation of conditions conducive to self-restoration of the spine. Of course, aggressive exercises cannot be performed. The most commonly used yoga or Pilates. Exercise therapy is also necessary in case of damage to the cords of the spinal cord, since in this case there is a decrease in tactile sensation, sensation of muscles and joints.
- Acupuncture (acupuncture) promotes the activation of nerve endings, which is achieved by irritating them.
Please note that the entire rehabilitation process must be strictly controlled by the attending physician. You can not self-medicate, so as not to cause even more harm to your he alth.
