Cervical Fracture With Associated Spinal Cord Injury Essay

Question:

Discuss about the Cervical Fracture With Associated Spinal Cord Injury.

Answer:

Introduction

An injury to the spinal cord involves a lesion to a section of the spinal cord that can be either reversible or irreversible depending on the extent of the injury. Its typical features include: inability to have proper control of both muscles and autonomic activities in regions of the body innervated by the affected region of the spinal cord. Recovery time is usually variable from patient to patient.

This report will clearly show the incidences and causes of spinal cord injuries in Australia and also indicate the various causes and types of spinal cord injuries. This will also include statistics from the Australian Spinal Cord Injury Registry (ASCIR).

Incidence and causes

According to ASCIR, 347 cases were reported during 2013-2014 with 111 resulting from non-traumatic causes and 236 from traumatic incidences (White & Black, 2016). The above statistic was from people aged above 15 years. In reference to the statistics, it also stipulated that 81% of traumatic spinal cord injuries were from the male population and an average of 23% of all the spinal cord injuries cases were sustained by people aged between 15-24 years (New & Baxter, 2015)

Non-traumatic causes of spinal cord injury include disc herniation, infectious conditions, cancer, myelopathy, spinal canal stenosis and vascular disorders. These are usually managed through proper taking of medication in incidences where there is an infection or various surgical procedures to ease or correct the cause of the problem.

Traumatic causes of SCI are usually not anticipated (Wilson & Voth, 2016). In Australia, ASCIR, 45% of all traumatic cases are due to land accidents. In land transport related SCI cases, motorcycle drivers accounted for almost 32% of all the cases, followed by motor vehicle drivers (23%) and motor vehicle passengers (18%). Falls contribute to 32% of all SCI cases with low falls contributing (17%) and high falls (15%) of all the cases. About 10% of SCI incidences were water related (Middleton & Piccenna, 2015).

Types of spinal cord injuries and the category of injury

There are two broad categories in which Spinal Cord injuries can be classified, these are complete and incomplete type of injuries. The incomplete type of injury is unique such that the spinal cord is only partially severed hence there is retention in some functions. This usually depends on the severity of the injury/lesion, there also must be preservation of sensation or motion in areas innervated by S4 to S5 (Ma & Chan, 2014).

There are three types of partial spinal cord injuries, these are; Anterior cord syndrome, Brown Sequard syndrome and Central cord syndrome (Hurlbert & Hadley, 2015). Anterior cord syndrome is as a result of lesion to the anterior part of the spinal cord, this usually affects both sensory and motor pathways of the spinal cord below the level of the lesion. Touch and proprioceptive senses are not usually affected

The other type of injury is the central cord syndrome which involves damage to the cervical spinal nerves. Symptoms after this kind of an injury include weakness in the arms, the legs are not usually affected. There is also loss of sensations below the level of injury and in some people, it may be accompanied by a lack of bladder control and an altered sexual function (Makhni & Swart, 2017).

Injury to one side of the spinal cord is what is termed as Brown Sequard Syndrome. Since it is rare for one to have a true hemi section the degree of its manifestation usually varies from person to the other. On the side in which the injury has occurred, one usually loses both motor and sensory functions involving vibration, touch and proprioception. Interestingly, on the other side of the injury, there is only loss of sensations involving pain and temperature. (Moskowitz & Schroeppel, 2018)

In complete SCI the spinal cord is usually fully severed and all sensual or motor functions are usually absent. However, with proper treatment and physical therapy, some functions may be regained (Jain & Brooks, 2015).

There are three types of spinal cord injuries, these are paraplegia, tetraplegia and triplegia. Tetraplegia being as a result of damage to the cervical spinal cord is usually the most severe. It usually results in a complete or incomplete sensory and motor loss of the four limbs and torso. Paraplegia is a term referred to lack of sensation and movement from the lower half of the body as a result of injury to the thoracic spinal cord. On the other hand, triplegia is termed as loss of both sensations and movement in one arm and the lower limbs, it is usually as a result of an incomplete injury to the spinal cord.

Australian community resource that is available for spinal cord injury patients.

South Australia Spinal Cord Injury Services (SASCIS) at Hampstead is a state-wide community resource center that provides specialists rehabilitative services for South Australia. A consultative service is also provided for pediatric spinal cord injuries.

There is an inpatient rehabilitation unit where admissions and referrals are handled. Range of services that are provided include rehabilitation, assessment, short term intervention and review. There is also an outreach rehabilitation team that give support to individuals to enable them to manage their new way of life after sustaining a spinal cord injury. This significantly affects the patient’s life as he/she learns on how to cope with his current situation and promotes quick recovery or rather improves his or her way of life (Callaway & Enticott, 2017).

Conclusion

Spinal cord injuries are devastating due to their bad prognosis since full recovery is usually not attained. Management involving physical therapy, surgery and medication are used to lessen the extent of the debilitation caused by the injury. In Australia there are numerous Medical and Research centers used to manage SCI, depending on the severity of the injury rehabilitation is usually self-tailored from person to person. Even though SCI is devastating there are various management and rehabilitative techniques put into place to promote quick recovery.

References

Callaway, L., Enticott, J., Farnworth, L., McDonald, R., Migliorini, C., & Willer, B. (2017). Community integration outcomes of people with spinal cord injury and multiple matched controls: A pilot study. Australian occupational therapy journal, 64(3), 226-234

Hurlbert, R. J., Hadley, M. N., Walters, B. C., Aarabi, B., Dhall, S. S., Gelb, D. E., ... & Theodore, N. (2015). Pharmacological therapy for acute spinal cord injury. Neurosurgery, 76(suppl_1), S71-S83.

Jain, A., Brooks, J. T., Rao, S. S., Ain, M. C., & Sponseller, P. D. (2015). Cervical fractures with associated spinal cord injury in children and adolescents: epidemiology, costs, and in-hospital mortality rates in 4418 patients. Journal of children's orthopaedics, 9(3), 171-175.

Ma, V. Y., Chan, L., & Carruthers, K. J. (2014). Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Archives of physical medicine and rehabilitation, 95(5), 986-995.

Makhni, M. C., Makhni, E. C., Swart, E. F., & Day, C. S. (2017). Central Cord Syndrome. In Orthopedic Emergencies (pp. 61-63). Springer, Cham

Middleton, J. W., Piccenna, L., Gruen, R. L., Williams, S., Creasey, G., Dunlop, S., ... & Dunn, J. A. (2015). Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part III: outcomes. Spinal cord, 53(10), 729.

Moskowitz, E., & Schroeppel, T. (2018). Brown-Sequard syndrome. Trauma Surgery & Acute Care Open, 3(1), e000169.

New, P. W., Baxter, D., Farry, A., & Noonan, V. K. (2015). Estimating the incidence and prevalence of traumatic spinal cord injury in Australia. Archives of physical medicine and rehabilitation, 96(1), 76-83.

White, N. H., & Black, N. H. (2016). Spinal cord injury (SCI) facts and figures at a glance. National spinal cord injury statistical center, facts and figures at a glance.

Wilson, J. R., Voth, J., Singh, A., Middleton, J., Jaglal, S. B., Singh, J. M., ... & Fehlings, M. G. (2016). Defining the pathway to definitive care and surgical decompression after traumatic spinal cord injury: results of a Canadian population-based cohort study. Journal of neurotrauma, 33(10), 963-971.

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