Transcript Spinal Cord Injury - NSIC

Spinal Cord Injury
What is a spinal cord injury?
• Spinal cord injury (or SCI for short) can happen when the spinal cord is
damaged from an accident, like a car accident, through an illness, like an
infection, or in some other way, like a fall or from a knife wound.
• Such damage causes 2 things:
- loss of physical movement known as paralysis
- loss of sensation (physical feeling) in your body below the
level of injury
What does the spinal cord do?
• The spine is made up of bones, ligaments (tissue that connects the
bones),discs, nerves and the spinal cord.
• The spinal cord is a collection of nerves that carry messages from the brain
to the rest of the body.
• You can think of the spinal cord as a big electrical cable made up of lots of
wires that sends information to and from the brain. It is protected by rings
of bone called vertebrae which go round the spinal cord. There are 33 of
these bones (or vertebrae) in the spine.
The vertebrae of the spinal cord
• 7 cervical – in the neck
• 12 thoracic – in the chest or upper back
• 5 lumbar – in the lower back
• 5 sacral – in the pelvic region
• 4 coccyx – tailbone of the spine
Your spinal cord injury is here
Injury Level ______
These vertebrae or bones are separated by discs or
shock absorbers and make up the curved structure of
the spine.
This picture shows the areas of the body that are
affected by your level of injury
What are the effects of a spinal cord injury?
• When the spinal cord is damaged, the messages from the brain cannot get
carried past the damaged part and so can’t tell your muscles to move.
• Being paralysed or paralysis means a loss of physical feeling and
movement.
• Spinal cord injury affects how our limbs (our arms and legs) work. It can
also affect all of our bodily systems because our spinal cord carries all the
information between the brain and the rest of the body.
This diagram shows how
information about touch,
pain and pressure travels
to and from the brain
through the sensory
nerves, the spinal cord
and the motor nerves.
When the spinal cord is
damaged it may have
difficulty in transmitting
information.
• Organs such as our stomach, bladder, bowel and lungs can be affected.
• Other problems include not being able to sweat or control our
temperature properly, having low blood pressure and experiencing
constant pain.
• The higher the injury, the more someone’s body is effected. That means
that if your injury happens higher up your back or neck, you will
experience more loss of physical feeling and movement.
• Loss of movement also depends on whether the spinal cord is completely
severed or only partly damaged. Very high injuries in the neck may affect
the nerves to and from the diaphragm (a muscle near the lungs), so
breathing will need to be helped with a ventilator.
Understanding spinal cord injury
‘What does the word ‘‘Tetraplegia’’ mean?’
• If the spinal cord has been damaged in your neck area (known as the
cervical region), you are said to be tetraplegic.
• Tetraplegia (also known as Quadraplegia) means that the legs, arms,
stomach and some chest muscles are paralysed.
• For example, C4 Tetraplegia means that your body is paralysed below the
neck. C6 Tetraplegia means that your hands and arms and lower body are
partially paralysed.
Understanding spinal cord injury
‘What does the word ‘’Paraplegia’’ mean?’
• Paraplegia means that the legs and possibly some stomach muscles are
paralysed but you will be able to move your arms.
• For example, T6 Paraplegia means that your body is paralysed below the
chest. L1 Paraplegia means that your body is paralysed below the waist.
Spinal cord injury can occur at any
level or multiple levels of the spinal
cord
What does ‘Complete’ and ‘Incomplete’ injury mean?
• In hospital, we use a special scale called the ASIA Impairment Scale to describe the type
of spinal injury you have. ASIA stands for American Spinal Injury Association.
• Using this scale, spinal injury can be described as Complete, Incomplete Sensory,
Incomplete Motor, and Normal.
Complete
• A complete injury is when the spinal cord has been fully damaged at any
level so that you can not move or feel anything below the level of your
injury, then your injury is said to be complete. Both sides of the body are
effected in the same way.
Incomplete
• An incomplete injury is when some messages to and from the brain can
still get past the damaged area so that you can move or feel some parts of
your body below the level of your injury.
• There are two types of incomplete injury: sensory incomplete and motor
incomplete:
• Sensory incomplete means that you are able to feel some parts of the
body that cannot be moved.
• Motor incomplete means that you are able to move some parts of the
body that cannot be felt. You may be able to move one limb and not the
other and have more use on one side than the other.
Autonomic Dysreflexia
• Autonomic Dysreflexia (or AD for short) is unique to spinal cord injuries.
What is AD?
• It is a sudden and dangerous rise in blood pressure triggered by an
exaggerated response to painful stimuli, below the level of spinal cord
damage.
• If AD is not treated or the cause remains unresolved, then it could be
fatal.
• AD can happen any time from the start of spinal paralysis. It happens in
both complete and incomplete injuries but usually only affects those with
an injury at the level T6 and above.
What happens to the body during an episode of AD?
Faecal
impaction
Symptoms:
•severe pounding headache
•flushed appearance of the skin
above the level of injury
•profuse sweating above the
level of the lesion
•nasal congestion
•feeling unwell
•blurred vision
•increase in spasm
•continued severe hypertension
(raised blood pressure)
Common causes of Autonomic Dysreflexia (AD)
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blocked catheter
constipation
a broken bone
ingrowing toenail
pressure ulcer
erection
menstrual problems
pregnancy/labour
Treatment of Autonomic Dysreflexia (AD)
AD needs to be treated urgently because it can be fatal. It is
important to find and treat the cause as soon as possible.
First things to do are:
• Treat the high blood pressure whilst identifying the cause
• Sit up to lower the blood pressure
• Check for possible causes so that the pain stimulus can be removed
• If the pain stimulus cannot be removed take 10mg Nifedipine under the tongue.
(Nifedipine patches are available and can be removed when the symptoms are
relieved).
• Seek prompt medical advice if the cause cannot be identified or the blood
pressure cannot be controlled
Prognosis in spinal cord injury
‘Why won’t my doctor tell me my prospects of recovery?’
When a spinal cord injury happens there may be some swelling around the
spinal cord. After days or weeks the swelling should go down and some
function may return.
Those who damage only part of the spinal cord may recover some
movement or feeling following the wearing off of the shock to the spine.
It can take up to two years for your body to recover from a spinal cord
injury so a clear prognosis is difficult to give, especially with incomplete
spinal cord injury.
‘How long will I have to be in hospital?’
It depends on your injury. People with Tetraplegia may need to stay in
hospital for up to 9 months and those with Paraplegia may need to stay in
hospital for up to 5 months. Rehabilitation can take a long time and this
depends on many factors.
‘Is there a cure for spinal cord injury?’
Although spinal doctors are able to fix the damage to the bones of the
spine, at the moment there is no way to repair the spinal cord itself. Once
the nerve cells of the spinal cord have been destroyed they cannot repair
themselves. You can access the most accurate research findings on the
following websites:
www.spinal-research.org
www.closerlookatstemcells.org