Injuries To The Spinal Cord

Types Of Sacral Spine Injury

Depending on the type of sacral injury or nerve damage, its location affects the nerves in that area and leads to lack of control and pain:

• S1 nerves affect the hips and the groin area.
• S2 nerves affect the backs of the thighs.
• S3 nerves affect the medial buttock area.
• S4 nerves affect the perineal area.

Pelvic organs are controlled by the nerves in the sacral region. These organs include the bladder, bowel and sex organs.

Diagnosing Spinal Cord Injury

Imaging using MRI or CT scans will provide information about a spinal cord injury including the type and level where the trauma occurred. This might not match up to your clinical exam as the injury could be at one level, but your level of function might indicate a higher level of injury due to swelling and other trauma or medical complications. To evaluate the functional outcomes of spinal cord injury, a physical examination is performed.

Spinal cord injury is evaluated using the International Standards for Neurological Classification of SCI . The same scale should be used to assess your spinal cord injury each time to be able to track your progress accurately.

Each level of the spinal cord is tested by assessing the dermatome or specific body section affected by the nerve at each level of the cord. In testing, motor ability is assessed by moving every joint in your body. Assessments are made to see if you can move under your own power, positioned so gravity is reduced, or unable to move. Sensation is assessed for gross and fine sensation. Both gross sensation, measured using a cotton swab, and fine motor sensation, measured using a sharp point, are tested. Sensation is measured by full feeling, feeling present but feels different and no feeling.

A. Complete injury. This means no function or sensation is assessed at the end of the spinal cord.

C. Motor incomplete. Motor function is present to the end of the spinal cord.

E. Normal. No residual affects assessed.

Complications Of Spinal Cord Injury

• Magnetic resonance imaging Magnetic Resonance Imaging In magnetic resonance imaging , a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe… read more : MRI is the best test for injuries of the spinal cord and the ligaments of the spine. However, CT is generally done before MRI is done because MRI is less readily available than CT and does not show injuries to bone in as much detail as CT.

Although MRI is best suited for assessing the spinal cord and ligaments of the spine, occasionally MRI is not possible due to implanted devices such as pacemakers. In these cases, CT myelography may be done. CT myelography is a CT scan done after doctors inject a radiopaque dye into the space around the spinal cord. CT myelography can show displaced structures that impinge on the spinal cord.

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Traumatic Brain And Spinal Cord Injury

A traumatic brain injury is a disruption of the normal function of the brain that can be caused by a bump, blow or jolt to the head or a penetrating head injury. While everyone is at risk for a TBI, children and older adults are especially vulnerable. Spinal cord injuries describe injuries to the spinal cord. Symptoms of SCI can include partial or complete loss of sensory function or motor control of the arms, legs or body. In severe cases, SCI can affect bladder and bowel control, breathing, heart rate and blood pressure.

Read more on traumatic brain injuries and concussions from the Centers for Disease Control and Prevention.

General Effects Of Injury To Sacral Nerves S1 To S5

There is no spinal cord in the sacrum region however, sacral nerve damage in the sacral spine may have symptoms similar to spinal cord damage. Typically, with a sacrum injury or sacrum fracture:

• Injuries generally result in some loss of function in the hips and legs.
• There may be little or no voluntary control of bowel or bladder organs, but people with this injury can manage on their own with special equipment.
• People with a sacral spinal cord injury will most likely be able to walk.

Damage to the sacral spine is rare and may only occur with a serious injury, such as a fall or trauma directly to the area. People who have osteoporosis or arthritis may develop stress sacrum fractures.

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Thoracic Vertebrae Are Located In The Mid

Thoracic Nerves

• Corresponding nerves affect muscles, upper chest, mid-back and abdominal muscles.
• Arm and hand function is usually normal.
• Injuries usually affect the trunk and legs.
• Most likely use a manual wheelchair
• Can learn to drive a modified car
• Can stand in a standing frame, while others may walk with braces

Thoracic Nerves

• Nerves affect muscles of the trunk depending on the level of injury.
• Usually results in paraplegia
• Fair to good ability to control and balance trunk while in the seated position
• Should be able to cough productively
• Little or no voluntary control of bowel or bladder but can manage on their own with special equipment
• Most likely use a manual wheelchair
• Can learn to drive a modified car
• Some can stand in a standing frame, while others may walk with braces.

How Do I Manage An Acute Spinal Cord Injury

SCIs impact all parts of a persons life. SCI management involves knowledge of both the skills needed for daily living and an awareness of common long-term problems that happen in people with paraplegia and quadriplegia.

Depending on the level of your injury, daily management skills include such things as how to:

• Cope with emotions such as fear, sadness, or anger
• Use a wheelchair
• Manage your bladder and bowel
• Exercise, to help you regain as much movement in your arms or legs as possible

Common long-term management problems in people with SCIs include:

• Emotional and money issues linked to the disability
• Urinary tract infections and kidney problems
• Damage to the skin and tissue under the skin caused by pressure
• Lung infections and breathing problems
• Weakening of bones
• Muscle and joint stiffness

There are many spinal cord injury treatment and rehab programs to help you deal with both short and long-term SCI management. These include:

• Acute rehabilitation programs
• Day-treatment programs
• Vocational rehabilitation programs

Talk with your family and your rehab team about short-term and long-term goals. Your rehab team can help you find treatment and rehab programs and local resources to help you and your family.

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A New Strategy Against Paralysis

MNT also spoke with Dr. S. Thomas Carmichael, Frances Stark Chair in the Department of Neurology at the David Geffen School of Medicine at UCLA, and secretary of the American Neurological Association, about this research.

He explained injuries such as spinal cord injuries damage neurons and their connections, disabling walking and other movement functions.

Many theories for this effect of damage hold that the damage directly disrupts the movement-controlling cells and their connections, and this is one cause of impaired walking, Dr. Carmichael continued.

However, scientific evidence also suggests that stroke, spinal cord, and traumatic brain injury also stun neurons that survive the injury, and these populations of surviving neurons cannot recover the lost function because they cannot fire together to mediate movement. This idea of a lack of ability of surviving neurons after brain and spinal cord injury to fire together in a coordinated sequence with their neighbors is supported by many studies in experimental models in the lab and in a correlative way in human studies.

Dr. S. Thomas Carmichael

Many in the field of neurorehabilitation assumed that spinal cord stimulation would mediate recovery of walking by facilitating the firing of neurons together in the proper sequence and within a new group of active neuronsa new network of neurons that takes over the function of walking, he added.

The Problem Of Pain After Sci

Pain is a serious problem for many people with spinal cord injuries . Pain after SCI can occur in parts of the body where there is normal sensation as well as areas that have little or no feeling. The pain is very real and can have a negative impact on quality of life. A person in severe pain may have difficulty carrying out daily activities or participating in enjoyable pastimes.

The majority of people with SCI report that they have chronic pain. Chronic pain is pain that does not go away and instead lasts months to years. The cause of the pain may be unknown but is most often related to nerve damage from the SCI or musculoskeletal problems that arise in dealing with an SCI. The pain can come and go. Chronic pain is difficult to completely eliminate but often can be managed or reduced enough so that it doesn’t overwhelm your life.

Chronic pain can cause or worsen psychological problems such as depression, anxiety and stress. This does not mean the pain is “all in your head,” but rather that pain and distress can make each other worse.

Even though pain after SCI can be complicated and difficult to treat, there are many treatments available that can help. Understanding your pain, working with your doctor and being open to a variety of treatments will help you manage your pain and improve your quality of life. Many people with difficult chronic pain problems after SCI have found relief using techniques described here.

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Symptoms Of Spinal Injuries

If the spine is injured, people usually feel pain in the affected part of the neck or back. The area over the injury may be tender to the touch, particularly if a fracture is present. If the spinal cord is injured, the nerves at and below the site of the injury malfunction, causing loss of muscle control and loss of sensation. However, children may have spinal cord injuries in which nerves malfunction only temporarily and briefly. They may have lightning-like pains that shoot down the arms or legs.

Exactly what and how much function is lost in the arms and legs depends on the location of the spinal cord injury. For example, if the spinal cord is injured in the neck, the person may lose movement and sensation in both the arms and the legs, whereas an injury farther down the spinal cord may result in dysfunction in the legs only. A person can lose control of the ability to urinate or have a bowel movement and lose sexual function regardless of the location of the spinal cord injury.

Partial loss of muscle control results in muscle weakness. Paralysis usually refers to complete loss. When muscles are paralyzed, they often go limp , losing their tone. Muscle reflexes that doctors check using a reflex hammer are weak or absent. But when the spinal cord is injured, paralysis may progress weeks later to involuntary, prolonged muscle spasms . In this case, muscle reflexes are stronger than normal.

Spinal Cord Injury Without Radiographic Abnormality

Spinal cord injury without radiographic abnormality exists when SCI is present but there is no evidence of spinal column injury on radiographs.Spinal column injury is trauma that causes fracture of the bone or instability of the ligaments in the spine this can coexist with or cause injury to the spinal cord, but each injury can occur without the other. Abnormalities might show up on magnetic resonance imaging , but the term was coined before MRI was in common use.

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Symptoms Of The Injury

There are several symptoms that can accompany spinal injuries

• Loss of movement
• Loss or altered sensation, including the ability to feel heat, cold, and touch
• Loss of bowel or bladder control
• Exaggerated reflex activities or spasms
• Changes in sexual function, sexual sensitivity, and fertility
• Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord
• Difficulty breathing, coughing, or clearing secretions from your lungs

• Extreme back pain or pressure in your neck, head, or back
• Weakness, incoordination, or paralysis in any part of your body
• Numbness, tingling, or loss of sensation in your hands, fingers, feet, or toes
• Loss of bladder or bowel control
• Difficulty with balance and walking
• Impaired breathing after injury
• An oddly positioned or twisted neck or back

If you have been in an accident that has left you experiencing any of these symptoms and you have yet to contact a physical therapist regarding your condition, know that our therapists can help to determine which areas of your body require immediate attention in regards to strength building, movement, control, and more.

Medical Imaging In The Cloud

There has been growing trend to migrate from on-premise to a PACS. A recent article by Applied Radiology said, “As the digital-imaging realm is embraced across the healthcare enterprise, the swift transition from terabytes to petabytes of data has put radiology on the brink of . Cloud computing offers the imaging department of the future the tools to manage data much more intelligently.”

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Secondary Conditions Due To Spinal Cord Injury

Besides a loss of sensation or motor function, injury to the spinal cord leads to other changes in the body. Your body is still working below the level of injury. It is just that messages to and from your brain are not being communicated through the site of injury. You will have to provide your body with the necessary care manually. Complications of spinal cord injury are possibly preventable with good healthcare, diet and physical activity although sometimes they occur even with the best of intentions. The chart below indicates the secondary complications of spinal cord injury and ideas about how to combat them.

Dealing With Intimacy Sexuality And Sexual Activity

Your spinal cord injury might affect your body’s sexual responsiveness. However, you’re a sexual being with sexual desires. A fulfilling emotional and physical relationship is possible but requires communication, experimentation and patience.

A professional counselor can help you and your partner communicate your needs and feelings. Your doctor can provide the medical information you need regarding sexual health. You can have a satisfying future complete with intimacy and sexual pleasure.

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An Overview Of Experimental Models Of Spinal Cord Injury

Animal models are also classified based on the type of SCI. The following sections will provide an overview on the available SCI models that are developed based on injury mechanisms, their specifications and relevance to human SCI .

Transection Models

A complete transection model of SCI is relatively easy to reproduce . However, this model is less relevant to human SCI as a complete transection of the spinal cord rarely happens . While they do not represent clinical reality of SCI, transection models are specifically suitable for studying axonal regeneration or developing biomaterial scaffolds to bridge the gap between proximal and distal stamps of the severed spinal cord . Due to complete disconnection from higher motor centers, this model is also suitable for studying the role of propriospinal motor and sensory circuits in recovery of locomotion following SCI . Partial transection models including hemi-section, unilateral transection and dorsal column lesions are other variants of transection models . Partial transection models are valuable for investigation of nerve grafting, plasticity and where a comparison between injured and non-injured pathways is needed in the same animal . However, these models lead to a less severe injury and higher magnitude of spontaneous recovery rendering them less suitable for development and evaluation of new therapies .

Contusive Models

Compressive Models

Leading Causes Of Spinal Cord Injuries Explained

Most spinal cord injuries are preventable, and knowing the causes of these injuries can help you avoid becoming a victim. And if you or someone you love already deal with the frustration and pain of a spinal cord injury, knowing the most common sources of these injuries can help you feel a bit less alone.

The National Spinal Cord Injury Statistical Center at the University of Alabama-Birmingham conducts annual spinal cord injury research, including an assortment of statistics on SCI injuries. It’s interesting to note that, in almost all categories of injuries, men are more likely to be injured than women.

In 2014, the most recent year for which statistics are available, the 10 leading causes of spinal cord injuries, and their percentage of the total number of injuries, were as follows:

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Common Causes Of Spinal Cord Injuries

The most common causes of spinal cord injuries in the United States are:

• Motor vehicle accidents. Auto and motorcycle accidents are the leading cause of spinal cord injuries, accounting for almost half of new spinal cord injuries each year.
• Falls. A spinal cord injury after age 65 is most often caused by a fall.
• Acts of violence. About 12% of spinal cord injuries result from violent encounters, usually from gunshot wounds. Knife wounds also are common.
• Sports and recreation injuries. Athletic activities, such as impact sports and diving in shallow water, cause about 10% of spinal cord injuries.
• Diseases. Cancer, arthritis, osteoporosis and inflammation of the spinal cord also can cause spinal cord injuries.

Prognosis For Spinal Injuries

Recovery is more likely if paralysis is partial and if movement or sensation starts to return during the first week after the injury. If function is not regained within 6 months, loss is likely to be permanent. However, several studies have shown that recovery is possible up to one year after injury.

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