Spinal Cord Injury Treatment

Spinal cord injuries can be devastating leading to partial or complete paralysis. Spinal cord injuries were once frequently fatal, but over the past fifty years many new treatments have been developed to help people with spinal cord injuries survive and possibly recover a great deal of function. Within the past twenty years, even more promising treatments have been developed for spinal cord injury.

Treatment of spinal cord injury may involve medication, and surgery, and always requires physical therapy. Spinal cord injury may be due to either traumatic or non-traumatic causes. Non-traumatic causes of spinal cord injury occur over time and include arthritis, cancer, infection, blood vessels problems, bleeding, and inflammation.

In the case of traumatic spinal cord injury due to an accident, immediate, comprehensive trauma care is crucial for both survival and long-term outcome. A competent trauma team can do much to minimize the spread of damage from a spinal cord injury. The long-term prognosis for a spinal cord injury depends on the nature and location of the injury, as well as the quality of care received.

If emergency medical personnel suspect you have sustained a spinal injury, they will do everything possible to prevent further injury. While medics work to stabilize your heart rate, breathing, and blood pressure, your head and neck will be put into a special brace to prevent movement and additional injury. You will be put on stiff back board to prevent injury while you are being loaded in the ambulance and taken to the hospital.

Once at the trauma center, doctors will continue to work to make sure that you are stabilized and that no further injury will occur. You will continue to be immobilized while undergoing tests such as CAT scans and MRIs; these imaging tests will help the doctors determine the extent of your injury.

In cases of severe injury to the neck area of the spinal cord, respiratory problems may occur. Doctors may need to help you breathe by giving you oxygen through a tube inserted down your throat; this process is called intubation.

Spinal cord injuries have a tendency to worsen after the initial injury. Blood pressure and blood flow may drop dramatically immediately after the injury or may remain fairly normal in the first few hours only to drop dramatically within a day or so. As blood pressure drops and blow flow decreases, inflammation sets in and nerve cells at a distance from the injury begin to die. Researchers still do not understand all of the reasons why the injury spreads in this way, but a corticosteroid drug first used for spinal cord injuries in the early 1990s may help reduce the extent of the spread.

Doctors may give you this powerful corticosteroid, methylprednisolone (Medrol). When given within eight hours of the initial injury, methylprednisolone has been known to prevent further damage and to promote recovery in some people. Methylprednisolone reduces nerve damage and decreases inflammation around the injury. The use of methylprednisolone is controversial. It can cause serious side effects and some doctors believe it provides little benefit; however, other doctors are convinced that the drug is worth the risks and should be used to in most spinal cord injuries.

During the first few hours and days after a traumatic spinal cord injury, doctors may need to operate remove foreign objects, bone fragments, fractured vertebrae or herniated disks that are compressing the spine (decompressive surgery). Sometimes surgery is necessary to stabilize the spine; however, the precise time to perform emergency surgery is controversial. Some doctors believe that the sooner such an operation is performed, the greater chance a patient has of full recovery. Other doctors are convinced that surgery should be postponed for several days, so that the patients condition will be more stable.

The debate over when to perform surgery is yet to be settled, but in 2008 a comprehensive study seemed to indicate that earlier invention is better. According to the Surgical Treatment of Acute Spinal Cord Injury Study (STASCIS) 24% of people who underwent decompressive surgery within a day of their initial injury showed significant improvement when measured by the American Spinal Injury Association (ASIA) scale. The condition of these patients improved by two grades or better on this scale. While doctors are encouraged by the studys results, it is still too early for a definitive decision on these results. More research must be done.

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Spinal Cord Injury Treatment