The spinal cord is the bundle of nerves that carries messages between the brain and the rest of the body. It passes through the vertebrae from the base of the brain down the back to the waist. The vertebrae and the spinal cord make up the spinal column, which is divided into three areas: the Cervical or neck, Thoracic or chest and Lumbar or lower back. Spinal cord injury results in neurological damage below the level of the injury. In a complete injury there is loss of sensation and motor function; in an incomplete injury there is some preservation of the sensory and/or motor function below the level of the injury.
The extent of dysfunction also depends on the location of the injury. For example, a lesion in the cervical spine results in quadriplegia – paralysis of the four limbs and trunk musculature. Injury to the lumbar spine generally results in paralysis of the legs and hips and in some cases may also involve the trunk. This type of dysfunction is known as paraplegia.
Spinal cord injuries may be caused by motor vehicle accidents, falls, high-impact sports injuries and diving accidents. Some diseases such as multiple sclerosis may also affect the normal functioning of the spinal cord. Rehabilitation of someone with a spinal cord injury is intensive and can last a lifetime. Physiotherapy plays a vital role in helping the spinal cord patient live a fairly functional existence.
Some complications of spinal cord injury
- Loss of motor and/or sensory control depending on the level of the injury.
- Bowel and bladder dysfunction.
- Sexual dysfunction, however women’s fertility is not affected.
- Breathing dysfunction especially in those with cervical or thoracic injuries. Patients may need ventilators or diaphragmatic pacemakers.
- Osteoporosis of disuse. Fractures may occur due to lack of use, particularly in the legs.
- Changes in blood pressure. Hypotension (low blood pressure) usually occurs when the patient changes his body position too quickly.
- Autonomic dysreflexia – a reflexive response to a distended bladder, faecal mass, pain or heat and resulting in pounding headaches, anxiety, sweating, chills, hypertension and the like. This is a medical emergency and life threatening.
Physiotherapy of the spinal cord patient will focus on:
- Maintaining or increasing joint range of motion and preventing deformity.
- Increasing strength of any functioning muscles.
- Increasing endurance for daily activities.
- Recommending and training in mobility aids.
- Gait retraining for those with lower extremity function.
- Home modification to ensure safety in getting around the home.
Spinal cord injury is an unfortunate occurrence. However, with advances in modern medicine and physiotherapy, we can help the injured person maximise the quality of his/her life. Give us a call.
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