Introduction
Spinal cord injuries impede the ability of the spinal cord to neural messages to other parts of the body. These injuries are frequently caused by an injury to the vertebrae that causes pressure, tearing or severing to the spinal cord in such a manner so as to affect the spinal cord functions. . In some cases, this damage may be caused by physical trauma, in others it may be the result of disease or congenital birth defects. .
According to the Foundation for Spinal Cord Injury Prevention Care & Cure in the year, 2009 there were approximately 259,000 people in the United States with spinal cord injuries caused by trauma. They found that the incidence of spinal cord injury from accidents were about 40 cases per million and resulted in 12,000 new cases each year. The predominant cause of injury (42.1%) was from motor vehicle accidents. . A worldwide study in 2006 determined that there was a range of 233 to 755 cases per million. However this study went on to conclude that sufficient data does not exist to reach a substantive result and improved data collection procedures should be instituted. . The Paralysis Resource Center on the Christopher & Dana Reeve Foundation includes all causes of spinal cord injury and reports that 1.9% of the U.S. population reported some form of paralysis resulting from spinal cord injury, 21% of which was caused by motor vehicle accidents. These figures were based upon data released by the United States Center for Disease Control and Prevention. .
Whatever the cause, trauma, disease or birth defect, the pathophysiology of spinal cord injuries varies depending upon what section of the spinal cord is injured and how severe the injuries are. Injuries above C3 are generally fatal and one vertebra down, those injuries that are above C4 commonly cause respiratory failure. If there is a complete transection of the spinal cord, the victim suffers a total loss of motor and sensory function below the level of the injury. If the transection is incomplete, the victim may retain some degree of function, either sensory or motor, below the level of injury. The types of disability are classed as follows:
- Tetraplegia (formerly quadriplegia)—loss of function in arms, legs, trunk, bowel, and bladder due to a cervical cord injury.
- Quadriparesis—weakness of both upper and lower extremities.
- Paraplegia—loss of function in legs, bowel, and bladder resulting from a thoracic, lumbar, or sacral cord injury.
- Paraparesis—weakness of lower extremities
Current treatment options are presently limited. Popular treatment plans include medication, surgery, bed rest, traction & immobilization and physical therapy & rehabilitation. Most of these treatment plans are most effective for traumatic injuries and are best commenced immediately following the traumatic incident. This is why Emergency Medical Technicians (EMTs) often immobilized accident victims immediately following an accident. Individuals who suffer a traumatic injury may have suffered a fracture that requires further diagnosis that that which can be performed at the scene of the accident. If they shift their position, they could do spinal cord damage that could otherwise be prevented. .
In the case of ongoing care, the Mayo Clinic reports that after stabilization, the focus then shifts to preventing secondary problems such as and muscular contractions & deconditioning, pressure ulcers & blood clots, bowel & bladder issues and respiratory infections. . Treatment for congenital and genetic spinal cord injuries varies more greatly as it is dependent upon treatment of the underlying physical cause and the treatment of that disease.
References
Boston Children's Hospital. (2012). Spinal Cause Injury. Retrieved 09 22, 2012, from Boston Children's Hospital: http://www.childrenshospital.org/az/Site1150/mainpageS1150P4.html
Brain and Spinal Cord. (2012). Spinal Cord Injury Treatment. Retrieved 09 22, 2012, from Brain and Spinal Cord: http://www.brainandspinalcord.org/spinal-cord-injury-treatment.html
Cadotte, D. W., & Fehings, M. G. (2011 , 03). Spinal cord injury: a systematic review of current treatment options. Retrieved 09 22, 2012, from Pub Med: http://www.ncbi.nlm.nih.gov/pubmed/21080129
Christopher & Dana Reeve Foundation. (2011). One Degree of Separation: Paralysis and Spinal Cord Injury in the United States. Retrieved 09 22, 2012, from Christopher & Dana Reeve Foundation: http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.5184255/k.6D74/Prevalence_of_Paralysis.htm
Dawodu, M. S. (2011, 11 10). Definitions and Pathophysiology. Retrieved 09 22, 2012, from Medscape: http://emedicine.medscape.com/article/322480-overview
Foundation for Spinal Cord Injury Prevention Care & Cure. (2009). Spinal Cord Injury Statistics. Retrieved 09 22, 2012, from Foundation for Spinal Cord Injury Prevention Care & Cure: http://www.fscip.org/facts.htm
Health Wise. (2011). Pathophysiology of Spinal Cord Injury. Retrieved 09 21, 2012, from Health Wise: http://nursingcareplanforpinoy.blogspot.com/2011/06/pathophysiology-of-spinal-cord-injury.html
Mayo Clinic Staff. (2012, 08 10). Spinal Cord Injury - Treatment and Drugs. Retrieved 09 22, 2012, from The Mayo Clinic: http://www.mayoclinic.com/health/spinal-cord-injury/DS00460/DSECTION=treatments-and-drugs
Mayo Clinic Staff. (2011, 10 22). Spinal Cord Injury. Retrieved 09 22, 2012, from The Mayo Clinic: https://www.mayoclinic.com/print/spinal-cord-injury/DS00460/METHOD=print&DSECTION=all
National Institute of Neurological Disorders and Stroke. (2012). Spinal Cord Injuries. Retrieved 09 22, 2012, from MedlinePlus: http://www.nlm.nih.gov/medlineplus/spinalcordinjuries.html
National Spinal Cord Injury Association. (2012). National Spinal Cord Injury Association. Retrieved 09 22, 2012, from National Spinal Cord Injury Association: http://www.spinalcord.org/
NSCIA. (2012). Spinal Cord Diseases. Retrieved 009 22, 2012, from NSCIA: http://www.spinalcord.org/resource-center/askus/index.php?pg=kb.printer.friendly&id=26
Shobab, L. (2012). Regaining Control: treatment options for spinal cord injury bladder dysfunction. Retrieved 09 22, 2012, from Journal of Young Investigators: http://www.jyi.org/features/ft.php?id=539
SpinalCord.Org. (2012). Spinal Cord Injuries. Retrieved 09 22, 2012, from SpinalCord.Org: http://spinal-cord.org/treatment-options.htm
Wyndaaele, M., & Wyndaele, J.-J. (2006, 01 03). Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Retrieved 09 22, 2012, from Nature.Com: http://www.nature.com/sc/journal/v44/n9/full/3101893a.html
