Spinal Nerve Injury

Spinal Nerve Injury

Spinal cord injury is a condition that causes damage to the nerves located in the spinal canal. Spinal cord injuries are generally caused by driving accidents, sports injuries, or physical abuse.

The spinal cord is a canal from the brain that extends from the neck to the coccyx. These nerves play an important role in the process of sending signals from the brain to the rest of the body and vice versa. If this nerve is damaged, there will be disturbances in several body functions, such as loss of the ability to move or feel something.

Injury to the spinal cord must be treated immediately. If treatment is not immediately carried out, the patient may need a longer recovery period. In addition, the possibility of worsening the condition or the emergence of complications will also be greater.

Causes of Spinal Nerve Injury

Spinal cord injuries can result from damage to the spine, the connective tissue between the vertebrae, or to the spinal cord itself. Spinal cord injuries are divided into two types based on the cause, namely traumatic and nontraumatic.

Traumatic spinal cord injury is an injury that occurs as a result of shifting, breaking, or dislocating the spine due to an accident, for example due to:

  • Motor vehicle accident
  • Fall during activity
  • Accident while exercising
  • Physical abuse

Meanwhile, nontraumatic spinal cord injuries are injuries caused by other conditions or diseases, such as:

  • Cancer
  • Inflammation of the joints ( arthritis )
  • Osteoporosis
  • Polio
  • Abnormal spinal growth from birth
  • Inflammation of the spine
  • Spinal tuberculosis , which can cause joint and spinal damage
  • Infections that cause abscesses in the spine

Risk factors for spinal cord injury

There are several factors that increase the risk of spinal cord injury, namely:

  • Male gender
  • Aged between 16–65 years or seniors aged over 65 years
  • Suffering from diseases related to bones and joints, such as osteoporosis or arthritis
  • Doing high-risk activities, such as doing extreme sports or driving without using safety equipment
  • Consuming alcoholic beverages
  • Have defects or abnormalities in bone growth since birth

Symptoms of Spinal Nerve Injury

The main symptoms that can usually be seen clearly in spinal cord injuries are motor disturbances in the form of muscle weakness and sensory disturbances in the form of numbness. Based on the severity of the injury, symptoms can be divided into:

  • Symptoms are not generalized or local ( incomplete )
    Incomplete symptoms occur when a nerve injury causes only a reduced ability to move (weakened movement) or feel.
  • Generalized symptoms ( complete )
    Generalized symptoms are characterized by the loss of all sensory and motor abilities so that the patient cannot move or feel at all.

Loss of the ability to move due to injury to the spinal cord can be further divided into two categories, namely:

  • Tetraplegia or tetraparesis
    Tetraplegia is muscle paralysis ( paralysis ) in both arms and legs, while tetraparesis is muscle weakness in the same location. This paralysis or weakness can also occur in the chest muscles, making it difficult for the patient to breathe and requiring a breathing apparatus. These symptoms occur due to injury to the spinal cord which is located in the neck.
  • Paraplegia or paraparesis
    Paraplegia is paralysis that occurs in the lower half of the body (both legs), while paraparesis is muscle weakness. This complaint usually occurs if the spinal cord injury occurs in the lower back.

Apart from motor and sensory symptoms, there are other symptoms that can occur as a result of a spinal cord injury. These symptoms can vary for each patient, depending on the location of the injury and the severity of the condition. Some of the common symptoms that appear in people with spinal cord injuries are:

  • Respiratory disorders
  • Sudden movement of certain body parts
  • Pain or stiffness in certain body parts
  • Unable to control urination or bowel movements
  • Decreased sexual desire
  • Pain or a stinging sensation in certain parts of the body
  • Headache

When to see a doctor

Check with your doctor if you experience the complaints mentioned above. Examination and treatment must be done immediately to prevent more serious injuries and complications.

In addition, if you experience serious trauma or injury to the head and neck, immediately consult a doctor even if you don't feel any symptoms. Trauma to the head and neck can cause spinal cord injury with late onset of symptoms.

Diagnosis of Spinal Nerve Injury

To diagnose a spinal cord injury, the doctor will ask about the symptoms and complaints experienced, medical history, and any medical procedures the patient has undergone. In patients who have had an accident, the doctor will ask about the incident in detail, especially how the patient experienced a collision.

After that, the doctor will perform a thorough physical examination, as well as a neurological examination which includes an examination of muscle strength and the patient's ability to feel touch, vibration, or temperature.

The doctor will also carry out several supporting examinations to see the condition of the patient's spine and spinal cord. The following are tests used in diagnosing spinal cord injuries:

  • X
    -rays X- rays are usually done if there is suspicion that there has been damage to the spine after an accident, such as a spinal fracture. X-rays can also be used to detect other disorders of the spine, such as tumors or arthritis.
  • CT scan
    This test serves to display a better picture of the spine than X-rays. The images produced by CT scans are taken from several angles so that they can show abnormalities that are not detected on X-rays.
  • MRI An
    MRI can help your doctor see soft tissue, such as the spinal cord itself and the soft tissue around it. It can also more accurately detect a herniated nucleus pulposus, blood clot, or tumor that may be pressing on the spinal cord.

Spinal Nerve Injury Treatment

As previously described, spinal cord injury can be traumatic or non-traumatic. In nontraumatic spinal cord injuries, treatment will be tailored to the underlying cause.

For example, an injury caused by a tumor can be treated with tumor surgery, radiotherapy, or chemotherapy. Meanwhile, injuries caused by arthritis can be treated with anti-inflammatory drugs and physiotherapy.

In injuries that occur as a result of an accident, the patient needs to be fitted with a neck brace immediately after the accident. This is to avoid movement of the spine which can make the injury worse.

After that, the patient will be placed on a special stretcher to be taken to the emergency room. In critical conditions after an accident, the emergency room doctor will take steps to maintain the patient's ability to breathe, prevent shock , and maintain spinal stability.

After the patient is stable, the doctor will begin providing therapy to treat the spinal cord injury itself. Some of the efforts made by doctors include:

  • Installation of traction
    Patients can be given neck and back supports or special beds, so that the head, neck or back does not move at all. This action is performed to prevent the patient's condition from getting worse and to return the spinal arrangement to its normal position.
  • Surgery
    If needed, the doctor will perform surgery to stabilize the position of the broken spine, removing pieces of bone, foreign bodies, or spinal fractures that are pressing on the spinal nerves.

Patients will also receive supporting therapy, such as fluid and nutritional infusions, feeding tubes, and urinary catheters. In some cases, patients need a ventilator to breathe properly.

Advanced treatment

For both traumatic and non-traumatic patients, the doctor will perform physiotherapy procedures after the patient's condition improves. However, the time it takes for patients to undergo physiotherapy can vary. The greater the damage, the longer it will take.

During the rehabilitation period, the patient will be directed by a doctor to train muscle strength and restore the ability to move. If needed, the doctor will give medicine to relieve pain.

Patients who have not recovered and are paralyzed are advised to use special supporting devices. One of the supporting equipment that can help spinal cord injury patients is an electric wheelchair.

The recovery period for spinal cord injuries usually lasts about 1 week to 6 months. However, in some cases, the time it takes for the patient to recover and be able to move freely can reach 1-2 years.

Complications of Spinal Nerve Injury

Complications that can occur due to spinal cord injuries are generally caused by limitations in the body's muscles in moving, including:

  • Shrinkage of muscle tissue ( muscle atrophy )
  • Weight gain because activity is very limited
  • Injuries to the back or buttocks due to immobility
  • Pneumonia due to non-optimal breathing movements
  • Constipation or constipation
  • leg swelling
  • Blood clots that can clog the leg veins

In addition there are also several other complications that can occur, namely:

  • Muscle stiffness
  • Urinary disorders
  • Urinary tract infection
  • Unstable blood pressure
  • Sexual dysfunction
  • Decreased fertility
  • Depression
  • Pain that doesn't go away in certain body parts

Prevention of Spinal Nerve Injury

In general, spinal cord injuries occur due to accidents. Therefore, take the following steps to prevent accidents:

  • Drive safely and obey the traffic signs.
  • Do not drive drunk or sleepy. Try to use a driver, public transportation, or take a break if you are in this condition.
  • Use safety equipment while driving or playing sports.
  • When doing outdoor activities, such as diving or rock climbing, discuss the risks and how to minimize them with an experienced instructor.
  • Be careful in your activities by paying attention to your surroundings, especially when on the stairs or in the bathroom.

If you see an accident victim who is at risk for spinal cord injury, here's what to do first aid :

  • Do not move the victim's body as this can worsen the condition.
  • Immediately contact the hospital so that the victim quickly gets medical help.
  • Place a towel or thick cloth on either side of the victim's neck so that the neck doesn't move. If the victim is conscious, tell him not to move.
  • Perform first aid, such as stopping the bleeding that occurs by dressing and pressing the wound with a clean cloth.
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