Best Treatment for Spinal Cord Injury
Twelve types of treatment options are available for people with spinal cord injury (SCI).

Immediate spinal cord injury (SCI) treatment can help avert worse consequences and is usually considered the best treatment option for SCI. Immediate treatment includes:

  • Immobilizing the spine and spinal collar placement
  • Immediate hospital admission

Surgery is typically performed to remove vertebral bone fragments and other things that are causing SCI. To relieve pressure on the spinal cord, surgery may be the best treatment option.

People with SCI usually require medical care to:

  • Manage their breathing.
  • Decrease the risk of pneumonia due to reduced chest movements.
  • Maintain healthy blood pressure.
  • Manage bladder problems with catheters.

Rehabilitation is what can help an SCI heal over time. This may entail physical therapy, occupational therapy, and educational training to obtain new employment. New adaptive technologies such as electronic wheelchairs, electrical stimulators, and computer-assisted technology can help people with impairments caused by an SCI live more independently.

12 treatment options for people with spinal cord injury

Twelve types of treatment options are available for people with spinal cord injury (SCI) including:

  1. Medications:
    • For acute SCI and edema, intravenous methylprednisolone is used as a therapeutic option. If this drug is administered within eight hours of the injury, the person may see a slight improvement. 
    • It aids in lowering nerve cell damage by reducing inflammation at the location of the injury. However, this may not be enough to heal SCI. 
    • Other drugs may be prescribed based on the person’s signs and symptoms.
  2. Immobilization:
    • Traction is essential to stabilize your spine and bring it into appropriate alignment. 
    • In certain circumstances, a hard neck collar may be effective, whereas a customized bed may assist in immobilizing the torso.
  3. Surgery:
    • Surgery can often help remove bone fragments, ruptured disks, foreign objects, or broken vertebrae that appear to be crushing your spine.
    • Surgery will be necessary to stabilize the spine and avoid future deformity or discomfort.
  4. Nerve transfer:
    • Nerves with the best control are relocated to the most critical muscle groups to offer control to previously paralyzed muscles. 
    • This is a novel technique for SCI that has numerous advantages in terms of functional recovery.
  5. Selective peripheral neurotomy:
    • Nerves are cut to minimize spasticity while maintaining function. This is frequently useful for enhancing walking or allowing clenched fists to open. 
  6. Phrenic nerve stimulator:
    • People who require a ventilator have the option of a surgically implanted phrenic nerve stimulator, which allows their breathing to work by diaphragmatic contraction (a more natural technique). This can frequently relieve them of their need for a ventilator.
  7. Regenerative treatment or cellular therapy:
    • It attempts to reverse cell death using human cells.
    • Human cells placed into the wounded part of the spinal cord are self-renewing and clever and capable of identifying which cells are required in the location and transforming into those cells. 
    • As a result, cellular treatment can reduce inflammation, halt cell death, encourage growth in existing cells, and replace damaged cells. If successful, this might help restore spinal cord function significantly.
  8. Epidural stimulation:
    • Electrical signals are reintroduced to the spinal cord. Because the nerve system loses touch with the brain and its messages after SCI, the stimulator functions to give the nervous system signals and stimulation that it no longer gets from the brain. 
    • The therapy is a surgical procedure to implant an epidural stimulator device underneath the level of damage, which delivers comparable signals to the spinal nerves and muscles that the brain typically sends.
  9. Spinal cord reconstruction:
    • Spinal cord reconstruction surgery is a type of sophisticated spinal surgery in which the spinal cord is attempted to be reconnected. 
    • The surgeon will remove scar tissue, divide the nerves and repair the injured spinal cord during the procedure. 
    • This is achieved by transplanting peripheral nerves from the person’s calf. These peripheral nerves are easy to reach, and their removal has little effect on the person’s calf function, making them the best source for this procedure. 
  10. Rehabilitation:
    • Rehabilitation (rehab) begins as soon as the person is stable. The purpose of treatment is to assist you to prepare for life after recovery and to be as self-sufficient as possible. What occurs in rehab is determined by the severity of your injury. Rehabilitation plays a vital role in the early stage of recovery.
  11. Mesenchymal stem cells:
    • They have been used in some cases for the therapeutic treatment of people with SCI since 2005. Recent research by several experts has led to the conclusion that stem cell transplantation helps in functional recovery following SCI.
  12. Combining SCI treatments:
    • These SCI therapies appear to be most successful when used together. The combined effect of therapy has yielded absolutely remarkable outcomes, restoring people’s freedom and dignity. 
    • As these combination treatments achieve growing effectiveness, they have become more widely available across the world. It will be great to watch how more use and research can enhance these therapies even further.

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What is spinal cord injury?

Spinal cord injury (SCI) is an extreme trauma to the spinal cord with far-reaching ramifications for the individual, family, and society. The World Health Organization classifies it as a major musculoskeletal ailment with a significant disease burden.

Depending on where you had SCI, you may have lost part or all sensation and muscle control in specific portions of your body.

The proverb "Prevention is better than cure" is true for most medical illnesses, but it is only comprehended once sickness strikes and SCI is possibly the cruelest of them.

Despite significant advances in understanding pathophysiological mechanisms after SCI in recent decades, a complete cure remains elusive. However, the expenses of managing it are significant.

Good rehabilitation can aid in the individual's reintegration into society, hence minimizing the impairment.

Types of spinal cord injury

Three types of spinal cord injury (SCI) depending on the type of injury include:

  1. Incomplete SCI:
    • If you have a partial injury, you may be able to move certain muscles or feel sensations beneath the damage location. 
    • People with this type of SCI may have a high chance of regaining muscle control and feeling.
  2. Complete SCI:
    • If you have a full injury, you cannot move your muscles or feel sensation underneath the damage site. 
  3. Spinal concussions:
    • They are SCIs that cause transient spinal cord dysfunction.
    • They might be full or incomplete, and they usually resolve themselves within 24 to 48 hours.
    • Sporting players are prone to head collisions, which can result in neck injuries, and as a result, they may be frequent victims of spinal concussions.

However, new research reveals that traditional definitions of complete and incomplete may not always be accurate. Ongoing physical examinations by your clinical team may assist define your type of damage and prospects for functional recovery.

Three types of SCIs depending on the location include:

  1. Tetraplegia or quadriplegia:
    • This is the most severe type and occurs when the damage is to the cervical spine (neck). This type limits or prevents the use of all limbs underneath the injury and can create complications with respiratory, digestive, bladder, and other functions.
  2. Paraplegia:
    • Injury to the thoracic spinal cord (middle back) might result in whole or partial paralysis of the person’s lower half.
  3. Triplegia:
    • Due to partial spinal cord damage, both legs and arms may lose mobility and sensation.
    • Although there was formerly little hope for rehabilitation, particularly for those with tetraplegia, advances in SCI treatment are now really improving individuals' prognoses.

The American Spinal Injury Association (ASIA) classifies SCIs into five types include:

  1. ASIA A: Complete SCI plus complete loss of movement and sensation
  2. ASIA B: Complete SCI with complete loss of movement
  3. ASIA C: Incomplete SCI with limited movement preserved, with less than half of muscles unable to lift extremities
  4. ASIA D: Incomplete SCI with limited movement preserved, with more than half of muscles unable to lift extremities
  5. ASIA E: Normal movement and sensation preserved

There have been numerous examples of individuals dying on their way to the hospital due to severe injuries. Thus, it is best to phone the emergency ward as soon as you see the damage.

10 causes of spinal cord injury

According to the World Health Organization, about 2 to 5 lakh individuals experience spinal cord injury (SCI) each year, most of which are caused by accidents or trauma.

In the general population, SCI increases the risk of mortality by two to five times, making it a major medical concern.

  1. Vehicular or road accidents
  2. Falls
  3. Violence
  4. Sports injury
  5. Cancer
  6. Arthritis
  7. Infections
  8. Deterioration of the spine
  9. Congenital disabilities
  10. Injury during birthing

Three possible risk factors for SCI include:

  1. Anyone who is at a high risk of injury is at a high risk of spinal cord damage.
  2. People with smaller-than-average spinal cords are at a high risk of spinal cord damage.
  3. Risky behavior, sports, and the existence of a bone or muscle condition may all increase the risk of spinal cord damage.

12 common signs and symptoms of spinal cord injury

Spinal cord injury (SCI) can damage any of the nerves that comprise the spinal cord or spinal canal. Moreover, impact or compression can cause nerve injury in the spinal cord. 

Symptoms will differ depending on whether the injury is in the cervical (upper), thoracic (middle), or lumbar (lower) spine.

  1. Severe pain or pressure in the head, back, or neck
  2. Loss of sensation or tingling in the hands, feet, or fingers or both
  3. Incontinence or urinary or intestinal retention
  4. Difficulty maintaining balance or walking
  5. A feeling of weakness in your limbs
  6. Loss of control of the legs (if the injury is in the lower back) and arms (if the injury is in the upper back)
  7. Difficulty breathing (if the injury is in the upper back)
  8. Problems with bowel and bladder function
  9. Loss of sexual dysfunction
  10. Spasticity (increased reflexes and stiffness of the limbs)
  11. Neuropathic pain
  12. Muscle wasting and weakness

SCI is one of the most serious injuries a person may sustain. As a result, you must take the necessary steps to secure your recovery and avoid future issues. The damage causes a great deal of discomfort. Therefore, avoid this circumstance by taking adequate precautions.

What is the prognosis of people with spinal cord injury?

It is critical to diagnose and treat spinal cord injuries (SCIs) as soon as possible to minimize lifetime problems. Never attempt to transfer an unconscious individual or someone who has lost function or sensation in their extremities. In an emergency, dial 911 for medical help.

The nature of SCI makes recovery time predictions challenging. Depending on the illness, recuperation might take anywhere from a week to six months. This can last up to two years or more and still result in negative outcomes.

According to the National Spinal Cord Injury Statistical Center, the occurrence of SCI among survivors is about 40 cases per million or approximately 12,000 new cases per year. 

  • In the United States, an estimated 273,000 people have SCIs, ranging from 238,000 to 332,000.
  • Men account for about 80 percent of all SCIs reported to the national database. 
  • Nearly half of all injuries occur in young individuals aged 16 to 30 years, yet the average age of injury has been progressively increasing.

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Medically Reviewed on 7/7/2022
References
Image Source: iStock image

What are the treatments for spinal cord injury (SCI)? https://www.nichd.nih.gov/health/topics/spinalinjury/conditioninfo/treatments

Spinal Cord Injury: https://www.webmd.com/pain-management/spinal-cord-injury-treatment

Spinal Cord Injury: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury

Spinal cord injury (acute management): https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Spinal_Cord_Injury_Acute_Management/

Spinal cord injury: https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury