What is a spinal cord injury?
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- Tyrone Stewart
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1 Spinal Cord Injury
2 What is a spinal cord injury? A spinal cord injury (SCI) is when the spinal cord is damaged Such damage causes 2 things: - loss or change of movement (paralysis) - loss or change of sensation (feeling) Spinal cord injury (SCI) can happen in different ways. How did it happen to you? Here are some other ways it can happen Falls - Road traffic accident Sport - Infection Illness - Tumour
3 The Spinal Column 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.
4 The vertebrae of the spinal column 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.
5 This picture shows the areas of the body that are affected by your level of injury
6 What are the effects of a spinal cord injury? Messages to and from the brain may not get past the damaged part of the spinal cord. This may cause a loss of change in sensation and/or movement. 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.
7 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.
8 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. 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.
9 Tetraplegia Any injury between C1-C8 (the neck area) Also known as Quadriplegia - means that the legs, arms, stomach and some chest muscles may be paralysed. Paraplegia Any injury T1 and below. It means that chest muscles and legs may be paralysed.
10 Spinal cord injury can occur at any level or multiple levels of the spinal cord
11 ASIA - Complete and Incomplete. 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.
12 Autonomic Dysreflexia Autonomic Dysreflexia (AD) 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. My normal blood pressure is 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.
13 What happens to the body during an episode of AD? Symptoms: Faecal impaction 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)
14 Common causes of Autonomic Dysreflexia (AD) blocked catheter constipation a broken bone ingrowing toenail pressure ulcer erection menstrual problems pregnancy/labour
15 Treatment of Autonomic Dysreflexia (AD) AD needs to be treated urgently because it can be fatal. What to do: Sit up to lower the blood pressure Check for possible causes so that the pain stimulus can be removed Bladder Bowel Skin If the pain stimulus cannot be removed take 10mg Nifedipine under the tongue. (GTN 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 Take written information about AD with you.
16 Prognosis in spinal cord injury 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. Frequently we can be accurate with prognosis early after spinal cord injury although in some cases prognosis can remain unclear for several weeks or rarely for months.
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