Rehabilitation of spinal cord injuries

h2>Abstract:

• Definition: Spinal cord injury (SCI) refers to the injury of the spinal cord ranging from the foramen magnum to the cauda equina, resulting from compulsion, incision, or contusion.
• Causes: The predominant causes of SCI globally include traffic accidents, gunshot injuries, knife injuries, falls, and sports injuries.
• Impact: SCI not only affects the independence and physical function of the patient but also leads to numerous complications post-injury.
• Complications: Some of the frequent complications after an SCI are neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular issues, and depressive disorders.
• Rehabilitation: Rehabilitation is a crucial and lengthy process, demanding the patience and motivation of both the patient and their relatives. Early rehabilitation is vital to prevent joint contractures, maintain bone density, and ensure the normal functioning of the respiratory and digestive systems. An interdisciplinary approach, involving a team led by a physiatrist and including the patient’s family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker, and other necessary specialists, is essential for effective rehabilitation.

Introduction:

• Prevalence: Every year, approximately 40 million people worldwide suffer from SCI. The majority of these patients are young men aged between 20 to 35, with 1% being children.
• Injury Mechanisms: Injuries can result from various mechanisms like flexion, compression, hyperextension, or flexion-rotation. The initial injury is termed “primary damage,” while the body’s subsequent responses, such as inflammation and hemorrhage, are termed “secondary damage.”

Classification:

The American Spinal Injury Association (ASIA) classifies SCIs based on motor and sensory functions. The classification ranges from ASIA-A (Complete injury with no sensory or motor function preserved) to ASIA-E (Normal sensory and motor function). The functional status post-injury is strongly related to whether the injury is complete or incomplete and the level of the injury.

Types of SCI:

• Tetraplegia: Refers to the impairment or loss of function in the cervical segments of the spinal cord, affecting both arms and typically the trunk, legs, and pelvic organs.
• Paraplegia: Refers to the impairment or loss of function in the thoracic, lumbar, or sacral segments of the spinal cord. Arm function is spared, but the trunk, legs, and pelvic organs may be affected depending on the injury level.