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 health and can permanently attach the patient to a wheelchair. Treatment and recovery is very long and carried out in a stationary mode.
Bruising of the spine, or rather, the spinal cord, is also called contusion. With this type of injury, the process of destruction of the substance of the spinal cord is observed, which may be partial or total. Also distinguishing features are hemorrhages, the presence of sites of ischemia, edema and necrosis.
Symptomatology
We’ll make a reservation right away: any severe back injury is accompanied by spinal shock. What is this condition? 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, there is:
- pallor of the skin;
- low pressure;
- depressed breathing;
- bradycardia.
Now no one can make an accurate diagnosis, it is necessary to wait until the restoration of nerve endings. Right now, symptoms will begin to appear that will help find the site of the injury and clarify its severity.
The entire spinal column of a person can be divided into the following departments:
- cervical;
- thoracic;
- lumbar;
- sacral;
- coccygeal.
According to statistics, the lumbar region is most often affected (43.2%), followed by the chest (41.4%), then the cervical (10.2%). We suggest analyzing the symptoms of each of these departments in more detail.
Neck
With a bruise of the spinal cord of the spine (cervical in this case), the following symptoms are observed:
- contusion;
- edema, the localization of which falls on the cervical spine;
- paralysis of the hands (it can be partial or complete);
- loss of sensitivity of the cervical spine;
- loss of mobility;
- impaired vision;
- hearing impairment;
- memory loss is possible;
- movements are not coordinated;
- pain and stiffness at the site of injury.
The victim must undergo radiation diagnostics, which shows the following:
- impulse conduction is impaired;
- there is a hemorrhage of blood vessels.
If the bruise was severe enough, then you can encounter an irreversible consequence - crushing of soft tissue.
Thoracic department
Please note that this is a sedentary part of the spinal column, which is limited to the mobile parts of the neck and lower back. Also, when considering the anatomical structure, it can be noted that the thoracic region has a very narrow spinal canal, which is a decisive factor in possible complications of injury.
Bruising in the area is very difficult to diagnose, and symptoms directly depend on the degree of damage. As a rule, the symptoms are masked by other disorders that are characteristic not only of this department of the spinal column, but also of other organs.
Manifestations:
- swelling;
- numbness of the tissue at the site of injury;
- heartache;
- disorders of the digestive tract;
- urination disorders;
- respiratory failure;
- hematomas.
Lumbar
Spinal cord contusion that occurred as a result of trauma 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 damage.
A severe bruise has very sad consequences, which can lead to impaired mobility of the spine. So, the patient cannot stand, sit or be motionless for a long time.
During rehabilitation, it is simply necessary to perform special exercises for the lumbar spine, since inaction can lead to poor blood circulation in the lower extremities and atrophy of muscle tissue.
In addition to all of the above, swelling of the ankle or ankle can be observed.
Causes
Please note that our spinal cord has very good protection on all sides. Thus, getting injured in this organ is not so simple. This becomes possible only with a strong mechanical effect on the spinal column of a person. Spinal cord injury can be obtained most often in three ways:
- Accident (this is the most common reason that can lead not only to injury, but also to other, more serious injuries; in this case, the victim may not even drive the vehicle);
- abnormal behavior in water;
- falling from height.
Injuries during an accident are possible in the following cases:
- sharp braking;
- hit in the trunk;
- a sharp tilt of the head forward and then back (or in reverse).
Bruising of the spinal cord with improper diving can be caused by muscle relaxation during free fall. Injuries from falling from a height are more likely to occur in children. I distinguish several types:
- falling from a person’s height;
- up to 1.5 meters;
- more than 1.5 meters.
At the same time, landing on the legs can cause more significant damage, because in this case there is a fracture of the spinal column in several places at once. In addition, the cause may be a stab in the back. Pay attention to the fact that this blow can even be inflicted by a blast wave, which can throw the victim back to a very long distance.
As a rule, spinal injuries lead to damage to the bone structure, nerve and vascular formations. At the same time, several factors that provoke the death of nerve endings are highlighted. These may be primary factors:
- pressure;
- direct stab in the back;
- gap;
- sprain.
Secondary factors:
- hypoxia;
- microcirculation disturbance;
- violation of electrolyte metabolism.
Types of injury
All spinal injuries can be divided into two broad groups:
- open type (integrity of the skin is impaired);
- closed type (the integrity of the skin is not broken).
Possible damage to the spinal column:
- tearing or sprain;
- fracture (types: compression, comminuted, explosive, marginal, horizontal, vertical);
- intervertebral disc injuries;
- dislocation;
- subluxation;
- spondylolisthesis.
The last term is understood to mean displacement of the vertebrae.
The following injuries are related to spinal cord injuries:
- concussion;
- squeezing;
- gap;
- spinal cord injury (concussion).
Possible complications
A bruise refers to organ damage that has occurred due to an impact of the spinal cord itself on the walls of the spinal canal. With this phenomenon, impulse conduction is disturbed, and this badly affects the overall work of the body. In the absence of qualified assistance, it is impossible to avoid consequences that directly depend on the severity of the lesion.
- A mild degree is very treatable 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.
- Moderate severity is more dangerous, since with such a bruise there is a violation of the integrity of the tissue of the spinal cord. If infection occurs, sepsis, the development of urinary tract diseases or bronchopneumonia are possible. Characteristic features of such injuries: hematomas, damage to nerve endings.
- A complete violation of conduction leads to injuries that are irreversible (necrotic phenomena, increased arterial and intracranial pressure, which can cause a heart attack or stroke). Thromboembolism, the development of articular contractures, vein thrombosis are also possible.
Urgent Care
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 render it, a sequence of actions that will not harm the injured person.
- To begin with, you should lay the person on a flat and solid surface (it is better if it is a shield).
- Apply ice to the injury site, this will help relieve swelling and partially anesthetize the damaged area.
- It is possible to administer an anesthetic if necessary, but upon the arrival of an ambulance, it is imperative to report what the victim took. This is necessary, since the arrived specialist will first 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
If a patient enters a hospital with suspected spinal injury, a comprehensive examination should be carried out, which includes the following procedures:
- examination by a neurologist who will help to make an accurate diagnosis and recognize the severity of the lesion;
- X-ray of the damaged area, allowing to find out whether there is damage to the vertebrae;
- CT scan;
- angiography;
- MRI (magnetic resonance imaging);
- myelography, which allows to recognize pathological conditions.
We will dwell on angiography in more detail - a procedure that allows you to determine the state of blood vessels. This is necessary for the recognition of hemorrhages. In this case, temperature and pain dissociated sensitivity disorders are observed. The manifestation of vegetative-trophic disorders with damage to the lateral horns is possible. Segmental disorders, conduction sensitivity disorders, pyramidal symptoms are observed, which can be explained by squeezing the lateral cords of the spinal cord.
There are two methods of treatment, the choice of which depends on the severity of the injury:
- medication (methylprednisolone, betamethasone, saline solutions, diuretics, magnesium sulfate);
- operative (performed only in case of severe injuries or compression of the organ).
Periods
Bruising of the spinal cord and other injuries of the spinal column pass through three periods. Briefly about them further:
- Intermediate - about two months after damage. A distinctive feature is contracture in the joints.
- The late period is one year. All this time, the victim should be under the supervision 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 on the second day after spinal shock. In the absence of restoration of functions, we are already talking about irreversible consequences.
After all the studies and treatment of spinal cord injury, it is necessary to proceed 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 calming effect due to the development of a special substance during a bite.
- Magnetotherapy has a beneficial effect on the restoration of nerve roots and improves impulse patency. In addition, the procedure helps to normalize blood supply.
- Physiotherapy. 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 name. The basis of this rehabilitation method is the creation of conditions conducive to independent 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 at the same time there is a decrease in tactile feeling, sensation of muscles and joints.
- Acupuncture (acupuncture) contributes to the activation of nerve endings, which is achieved by irritating them.
Please note that the entire rehabilitation process should be strictly monitored by the attending physician. You can not self-medicate, so as not to inflict even greater harm on your health.