Spinal Cord Injuries
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What is the spinal cord? What is its importance?

The spinal cord is the nerve bundle that is part of the central nervous system as an extension of the brain and is located inside the spinal canal. All nerves that reach our arms and feet, and a series of nerves that reach the muscles of the rib cage, bladder, intestine, and genitals, come out of the spinal cord.

What are the causes of spinal cord injury?

The spinal cord extends from the brain to the neck, back, lumbar and sacral region across the spinal canal in the middle of the spine. Spinal cord damage occurs as a result of damage to the spine for multiple reasons, such as traffic accidents, and it is one of the most common causes of spinal cord injuries in the world, as well as falling from a high place, firearm injuries and sports injuries, especially jumping in shallow waters, and it is one of the most common sport related causes of spinal injuries. Regardless of the painful causes, spinal cord injury can occur due to painless causes such as spinal cord tumors, spinal cord infections and motor neuron diseases.

What is the clinical condition that we notice after a spinal cord injury?

Different types of paralysis occur, depending on the level of infection.

What does paraplegia (hemiplegia) and quadriplegia (tetraplegia)
mean?

Quadriplegia (tetraplegia) occurs as a result of a spinal cord injury at the level of the cervical vertebrae, in which the patient suffers from a lack of or problems in sensory and motor in the arms, trunk, legs, and pelvic areas.

As for the paraplegia (hemiplegia), it occurs as a result of a spinal cord injury at the level of the thoracic or lumbar vertebrae, in which the patient suffers from a lack of or problems in sensory or motor in the legs and pelvic organs.

What is complete injury and incomplete injury?

If the spinal cord is completely damaged in the level at which the injury occurred in the spine, then a complete loss of sensation and movement occurs in the area below the injury level. Therefore, it is called complete injury and is called ASIA A.

If the spinal cord is partially damaged, then the loss of sensation or movement will also be partial below the level of the injury, which is called incomplete injury and it called ASIA B, C, D, E depending on the motor condition.

What are the problems that can be observed and seen in patients?

The most important and obvious thing is complete or partial loss of sensation and movement below the level of injury.

We also notice problems with control and sensation in the urine and related urinary tract problems, and in the event that the patient is not able to empty the bladder appropriately, serious problems may occur in blood pressure, and if adequate rehabilitation of the bladder is not done, the patient may face several problems that may lead to kidney failure in the years following the injury. The patient may also notice problems with bowel movement. And since the patient is lying down continuously, bed wounds and bedsores may appear if they are not followed up well, as the treatment and healing of bedsores is very difficult. And due to the non-use of muscles and bones, limitation of joint movement may occur. The patient may also suffer from severe muscle cramps and spasms, which are problems that prevent the implementation of rehabilitation programs and affect the quality of life of the patient. In addition, some problems with sexual function may occur in patients with spinal cord injuries.

Do injured people benefit from rehabilitation?

Unfortunately, if the injury is complete, the patient cannot restore the motor ability or sensation.

For patients with a partial injury in the spinal cord, the patient can observe a partial or complete return to the sensation and movement within several months or years.

Early and advanced rehabilitation is necessary for injured patients, whether the injury is complete or incomplete, in order to prevent the above mentioned problems and so that the patient can continue his life independently using the remaining functions in the best way.

What is being done to rehabilitate spinal cord injuries?

The goal for patients with spinal cord injury is to prevent complications and ensure independence in the patient’s life. Attempting to regain strength in the muscles is the main goal. for this purpose, a range of manual treatments, movement exercises, stretching exercises and muscle strengthening exercises are applied in addition to modern techniques such as robotic therapy such as Lokomat  (walking robot), Armeo Power robot (for arm and hand) , Amadeo robot (for palm and fingers), hydrotherapy, functional neuromuscular electrical stimulation and transcranial magnetic stimulation techniques.

The bladder and intestine are emptied during the rehabilitation program at regular intervals and continuous follow-up. Air mattress is used to prevent bed sores and bed exercises are done to prevent muscle spasm or calcification of the joints. The patient is also placed in a vertical position whenever possible using support devices.

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