The spinal cord serves as a messenger for the body. It carries information from the brain to the rest of the body and back to the brain. The brain and spinal cord together make up the Central Nervous System (CNS).
The main functions of the central nervous system are:
Processing information received through sensory systems & other parts of the body
Activating appropriate actions/response to external or internal stimuli
Spinal Cord Injury
The spinal cord acts as the primary pathway for messages to be transmitted between the brain and the nervous system. The sensory information from the skin, muscles, & joints is carried to the brain, & the message from the brain is sent back to the peripheral nervous system. The peripheral nervous system connects the central nervous system to the body, serving as a link between the brain and spinal cord. In addition, the spinal cord contains motor neurons that are responsible for voluntary movement.
Types of Spinal Cord Injury:
Cervical Spinal Cord Injury: Injury in the cervical section of the spinal cord is the most severe, as it is located closest to the brain. Such an injury will result in tetraplegia or paraplegia - a total or partial paralysis of the lower part of your body.
Thoracic Spinal Cord Injury: The thoracic spine is located in the upper and middle part of the back. It manages the stability and balance of the body. Injury to this section can lead to paraplegia of the lower back muscles and legs.
Lumbar Spinal Cord Injury: The lumbar spine is located below the thoracic section and is the lowest major part of the spinal cord. It features longer vertebrae and carries the maximum weight of all the sections of the spinal cord. An injury to the lumbar spinal cord results in loss of function in the hips and legs.
Sacral Spinal Cord Injury: The sacral spine is situated below the lumbar spine and above the tailbone (coccyx). Injury to the sacral spinal cord is rare and occurs only with a serious incident like a fall or trauma to the area.
People with arthritis or osteoporosis may also be at risk of a sacral spinal cord injury. Nerves in the sacral spine region control pelvic organs like the bladder and sex organs. Injury to this region may lead to a total or partial loss of voluntary control of bowel movements. However, it can be managed with specific equipment.
Classification of Spinal cord Injury:
Complete Spinal Cord Injury: Causes a total loss of all motor and sensory functions below the injured section.
Incomplete Spinal Cord Injury: This allows a person to move partially, below the injury level. It is also called Incomplete Tetraplegia.
Degenerative Disc Disease
Degenerative Disc Disease (DDD) or Spondylosis refers to the gradual deterioration of the disc between the vertebrae in the backbone. This is a common disorder for people over 40 as the chances increase with age. It is a disease of wear and tear & commonly happens in the lumbar spine (low back). However, it can occur anywhere in the spine.
Common symptoms are – Pain in the neck and lower back, weakness, numbness, and shooting pain in the arms & legs.
Major Causes of Degenerative Disc Disease (DDD):
Inflammation: Disk inflammation can lead to muscle tension and cause painful muscle spasms. Inflammation, especially in the nerve roots can lead to radiating pain and numbness in the arms and shoulder (due to cervical disk degeneration), as well as hips and legs (in cases of lumbar disk degeneration).
Abnormal Micromotion: Micromovements between vertebrae can also cause great pain. Caused due to the degeneration of the outer disk layer, micromotions can irritate the nerve roots, muscles, and joints and progressively lead to major spinal instability causing intense bouts of pain.
Degenerative Disc Disease requires surgery very rarely. The commonly used non-surgical treatments include anti-inflammatory medicines, physiotherapy, and exercise programs.
Recommended Physical Therapy:
Physical therapy is the most recommended method for maintaining healthy movement of the spine.
The common symptoms include:
Stretching exercises for muscles, as pain is often caused due to tightness in these muscles.
Strengthening exercises that build muscles.
Low-impact aerobic exercises elevate the heart rate, improving blood circulation & thus enhancing the delivery of nutrients and oxygen to the body’s tissues that need healing. Activities like walking, swimming, and water aerobics are good options.
Treatment of the Spine Disorders
The aim of Spinal Cord Injury treatment is to prevent further damage and provide relief to patients.
Medications: Your doctor will prescribe medication for pain management and preventing further deterioration
Immobilization: Traction is needed to stabilize the spine, & bring it into proper alignment. In some cases, a rigid neck collar may work. A special bed also may help immobili ze the body.
Surgery: Often surgery is necessary to remove fragments of bones, foreign objects, herniated disks, or fractured vertebrae that appear to be compressing the spine. Surgery may also be needed to stabilize the spine to prevent further pain or damage.
Experimental treatments: Scientists are continuously trying to figure out ways to stop cell death, control inflammation and promote nerve regeneration.
Surgery is required when the patient has very severe symptoms, pain interferes with day-to-day activities, and non-surgical treatment has failed after a reasonable period of time.
Fusion surgery is usually done and this permanently stops the motion of the spine at the level of the degenerated disc.
Keyhole surgery or microdiscectomy spine surgery is typically performed when there is a prolapsed disc in the lumbar (lower back) region that is pressing against a nerve.
Disc replacement surgery where an artificial disc is implanted into the spine to imitate the functions of a normal disc (carrying weight and allowing motion). Artificial discs are usually made of metal or plastic-like (biopolymer) materials or a combination of the two. The treatment for bulging disc and prolapsed disc is a disc replacement done in the cervical (neck) spine.
Consult your doctor to decide on a suitable surgery required in your condition.
Rehabilitation Post Treatment
After the patient’s condition stabilizes, doctors turn their attention to preventing secondary problems that may arise. These are deconditioning (change in previously learned behavior), muscle contractions, pressure ulcers, bowel and bladder issues, respiratory infections, and blood clots.
Rehabilitation specialists will help strengthen muscle function, redevelop motor skills, and learn techniques to accomplish daily tasks with minimal help. Introduction to some new technologies can make coping simpler. Automated wheelchairs, robotic gait training, electronic applications, etc are some of the technologies that aid a patient in getting back to routine life.
Doctors & Hospitals
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Ruby General Hospital, Kolkata
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