Why is spinal cord damage permanent

Paramedics or other emergency medical services personnel carefully immobilize the entire spine at the scene of the accident. In the emergency department, this immobilization is continued while more immediate life-threatening problems are identified and addressed.

If the patient must undergo emergency surgery because of trauma to the abdomen, chest or another area, immobilization and alignment of the spine are maintained during the operation. For many injuries of the cervical spine, traction may be indicated to help bring the spine into proper alignment.

Standard ICU care, including maintaining a stable blood pressure, monitoring cardiovascular function, ensuring adequate ventilation and lung function and preventing and promptly treating infection and other complications, is essential so that SCI patients can achieve the best possible outcome. Occasionally, a surgeon may wish to take a patient to the operating room immediately if the spinal cord appears to be compressed by a herniated disc , blood clot or other lesion. This is most commonly done for patients with an incomplete SCI or with progressive neurological deterioration.

Even if surgery cannot reverse damage to the spinal cord, surgery may be needed to stabilize the spine to prevent future pain or deformity. The surgeon will decide which procedure will provide the greatest benefit to the patient.

Persons with neurologically complete tetraplegia are at high risk for secondary medical complications, including pneumonia, pressure ulcers and deep vein thrombosis. Recovery of function depends upon the severity of the initial injury. Unfortunately, those who sustain a complete SCI are unlikely to regain function below the level of injury.

However, if there is some degree of improvement, it usually evidences itself within the first few days after the accident. However, your rehabilitation team will help you develop tools to address the changes caused by the spinal cord injury, in addition to recommending equipment and resources to promote quality of life and independence.

Areas often affected include:. Bladder control. Your bladder will continue to store urine from your kidneys. However, your brain might not control your bladder as well because the message carrier the spinal cord has been injured.

The changes in bladder control increase your risk of urinary tract infections. The changes may also cause kidney infections and kidney or bladder stones. During rehabilitation, you'll learn ways to help empty your bladder. Pressure injuries. Below the neurological level of your injury, you might have lost some or all skin sensations. Therefore, your skin can't send a message to your brain when it's injured by certain things such as prolonged pressure.

This can make you more susceptible to pressure sores, but changing positions frequently — with help, if needed — can help prevent these sores. You'll learn proper skin care during rehabilitation, which can help you avoid these problems. Circulatory control. A spinal cord injury can cause circulatory problems ranging from low blood pressure when you rise orthostatic hypotension to swelling of your extremities.

These circulation changes can also increase your risk of developing blood clots, such as deep vein thrombosis or a pulmonary embolus. Another problem with circulatory control is a potentially life-threatening rise in blood pressure autonomic dysreflexia. Your rehabilitation team will teach you how to address these problems if they affect you. Respiratory system. Your injury might make it more difficult to breathe and cough if your abdominal and chest muscles are affected.

Your neurological level of injury will determine what kind of breathing problems you have. If you have a cervical and thoracic spinal cord injury, you might have an increased risk of pneumonia or other lung problems. Medications and therapy can help prevent and treat these problems.

Fitness and wellness. Weight loss and muscle atrophy are common soon after a spinal cord injury. Limited mobility can lead to a more sedentary lifestyle, placing you at risk of obesity, cardiovascular disease and diabetes.

A dietitian can help you eat a nutritious diet to sustain an adequate weight. Physical and occupational therapists can help you develop a fitness and exercise program. You can see on the device how much air is being taken into the lungs. The nurse or therapist will help you to set goals for using this breathing device. Families are welcomed to be involved in helping you use the incentive spirometer. The brain normally controls blood pressure and heart rate.

Signals from the brain send messages through the spinal cord to constrict blood vessels and raise the heart rate to keep the blood pressure and heart rate normal. When these signals cannot get through, a person can have low blood pressure and slow heart rate. Blood pressure may drop when the head of the bed is raised suddenly because blood vessels below the level of injury are dilated.

They cannot constrict fast enough to prevent low blood pressure. This is called orthostatic hypotension. To lessen your risk of this, the head of the bed is gradually raised, and an abdominal binder may be used.

A person may not be able to sweat or make goose bumps below the level of injury. The body cannot adjust its temperature. A person may feel cold and need blankets, then later, feel hot and need a fan or to be uncovered.

People at highest risk for this condition are those with SCIs above T6. This tends to happen after the spinal shock phase. Autonomic hyperreflexia happens because nerve messages that used to go up the spinal cord to the brain are blocked.

Autonomic hyperreflexia is a serious condition and needs to be treated right away. Prevention and looking for signs are very important. Stroke, heart attack, or seizures can happen if this is not treated. This is a condition that may happen throughout the rest of your life. A DVT is a blood clot that can develop in the legs and arms. It is often caused by a lack of movement. A blood thinning medicine may be used, or a filter may be placed in a blood vessel. Regular exercise of the arms and legs, and turning will be done to help prevent DVTs from forming.

Sometimes after an SCI, the stomach and intestine will stop working for a short time. This is called an ileus. Even though the stomach may not be working, it still makes acid. The acid may damage the stomach lining and cause stomach ulcers if it is not removed. A nasogastric NG tube may be placed through the nose into the stomach.

This tube will be used to help remove stomach acids. Medicines may also be given to help prevent stomach ulcers. Higher cervical injuries may make it harder to swallow. If this happens, an NG tube may be needed for nutrition and medicines. The tube is placed through the nose into the stomach. Liquid formula will be given either continuously or several times a day. The hospital dietitian helps the health care team choose a formula based on your calorie and fluid needs.

A spinal cord injury can cause ongoing neurological problems that require further medical follow-up. Sometimes, surgery is needed to stabilize the spinal cord after acute SCI. This test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

An imaging test that uses X-rays and computer technology to produce detailed images often called slices of the body. A CT scan shows images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays. Magnetic resonance imaging MRI. This test uses large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body. SCI requires emergency medical attention on the scene of the accident or injury.

After an injury, your head and neck will be immobilized to prevent movement. This may be very hard when you are frightened after a serious accident. There is currently no way to repair a damaged or bruised spinal cord. But, researchers are actively seeking ways to stimulate spinal cord regeneration. Surgery is sometimes needed to evaluate the injured spinal cord, stabilize fractured backbones, release the pressure from the injured area, and to manage any other injuries that may have been a result of the accident.

Your treatment may include:. Bladder catheter. A tube that is placed into the bladder that helps to drain urine into a collection bag. Feeding tube placed through the nostril to the stomach, or directly through the abdomen into the stomach, to provide extra nutrition and calories.

Recovery from a SCI often requires long-term hospitalization and rehabilitation. An interdisciplinary team of healthcare providers, including nurses, therapists physical, occupational, or speech , and other specialists work to control your pain and to monitor your heart function, blood pressure, body temperature, nutritional status, bladder and bowel function, and attempt to control involuntary muscle shaking spasticity.

There is no sure way to prevent SCI, but there are many steps you can take that might lower your risk, including:. Wear a helmet when riding a motorcycle or participating in any sports or activities that may result in head injury bike riding, skiing, hockey, football, etc. Physical therapy will likely be a very important part of your rehabilitation.

In this treatment, specialists will work with you to prevent muscle wasting and contractures, and to help you retrain other muscles to aid in mobility and movement. Another type of therapy is occupational therapy, which helps you learn new ways of doing everyday tasks in spite of your new physical limitations. A traumatic event that results in a SCI is devastating to both you and your family.

The healthcare team will help educate your family after hospitalization and rehabilitation on how to help care for you at home and understand the specific problems that require immediate medical attention.