About Spinal Cord Injury (SCI)
The cause of SCI involves a complex set of events and processes that affect the nervous, vascular, and immune systems. The primary phase of SCI involves an initial mechanical insult, such as contusion or compression, which leads to damage to upper or lower motoneurons and local events like axon severing and cell death. This mechanical trauma also causes hemorrhage, disruption of the blood-spinal cord barrier, and hypoxia.
Non-modifiable risk factors are factors that cannot be changed or controlled. These include:
- Age: Older individuals are at a higher risk of SCI due to factors like decreased bone density and increased risk of falls.
- Gender: Males are more likely to experience SCI than females.
- Anatomical factors such as a narrow spinal canal or misaligned vertebrae, can increase the risk of SCI.
Modifiable risk factors are factors that can be influenced or changed. These include:
- Alcohol and drug use: Intoxication increases the likelihood of accidents that can lead to SCI.
- Risky behavior: Engaging in activities like diving into shallow water or not using seatbelts increases the risk of SCI.
- Violence: Involvement in altercations or acts of violence can result in SCI.
It's important to note that these risk factors do not guarantee the development of SCI but may increase the chances. Always consult with a healthcare professional for personalized advice.
The most common early symptoms of SCI include:
- Numbness, tingling, or changes in sensation in the hands and feet
- Paralysis that may occur immediately or develop over time as swelling and bleeding affect the spinal cord
- Pain or pressure in the head, neck, or back
- Loss of movement
- Weakness or inability to move any part of the body
As the SCI progresses or becomes more severe, other common symptoms that may occur include:
- Unnatural positions of the spine or head
- Loss of bladder and bowel control
- Problems walking
- Difficulty breathing
- Changes in sexual function
It's important to note that these symptoms can vary depending on the location and severity of the spinal cord injury. It's always best to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
To diagnose SCI, the following examinations, tests, and procedures are commonly performed:
- Neurological examination: This involves assessing movement, sensation, breathing, responsiveness, and weakness at or below the level of injury.
- Magnetic Resonance Imaging (MRI): This imaging technique provides detailed three-dimensional images of the spinal cord and surrounding structures. It can detect brain and spinal trauma, herniated discs, vascular irregularities, bleeding, inflammation, and ligament injuries.
- Computed Tomography (CT): CT scans produce rapid two-dimensional images of organs, bones, and tissues. It can detect bone fractures, bleeding, and spinal stenosis.
- X-rays: X-rays provide two-dimensional images of the body, such as the spine. They can help identify misalignment or fractures in the vertebrae.
To determine the stage or severity of SCI, additional examinations and assessments may be performed, including:
- American Spinal Injury Association Impairment Scale: This scale is commonly used to assess SCI severity and determine prognosis.
- International Standards for Neurological Classification of SCI (ISNCSCI): This classification system helps classify individuals with SCI based on neurological examination findings.
- Assessment of neuropathic pain: Pain assessment guidelines are followed to evaluate central neuropathic pain associated with SCI.
It's important to note that these examinations and tests should be conducted by healthcare professionals experienced in diagnosing and treating SCI.
The goals of treatment for SCI are to:
- Remove compression factors and restore spinal stability: This is achieved through surgical procedures that aim to relieve persistent compression and prevent further damage to the spinal cord tissue.
- Promote nervous system regeneration: Neural tissue engineering methods, such as cell transplantation and bio/chemical molecular signaling, are being explored to repair and re-establish functional neural connections, nervous tissue, and cells. Neural stem cells (NSCs) play a crucial role in the regeneration of cells in the spinal cord.
- Improve functioning, mobility, and independence: Rehabilitation plays a vital role in helping individuals with SCI regain the highest possible level of functioning and independence. Strength and endurance training have shown significant improvements in strength, physical fitness, and quality of life for individuals with SCI.
- Manage secondary complications: Health behavior changes, such as maintaining a higher fitness level through regular exercise, can help prevent complications like cardiovascular diseases, diabetes, obesity, and depression associated with SCI.
- Medications: These may include glucocorticoids and sodium channel blockers that help enhance neuron survival, reduce inflammation, and regulate glutamine release. However, medication dosing may be affected by various factors, so it's important to consult with a healthcare professional.
- Therapies and therapeutic procedures: These include cerebrospinal fluid drainage, blood pressure changes, and therapeutic hypothermia. These interventions aim to reduce oxidative stress, improve blood supply to the injured area, and protect the central nervous system.
It's important to note that while some progress has been made in SCI treatment, there is currently no successful or effective treatment that can fully restore function or regenerate injured nerves. Research is ongoing to explore new approaches for SCI treatment. It's essential to consult with a healthcare professional or refer to medication information for additional side effect information.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.