Prof. Dr. Erkan Kaptanoğlu

Diseases

Spinal Cord Injury and Spinal Cord Paralysis

Every year, thousands of people face spinal cord paralysis as a result of traffic accidents, jumping into the sea or sports injuries. When trauma occurs on the spine, the vertebrae may break or slip. As a result of this fracture or displacement, the spinal cord and nerve tissue inside the spine may be injured. When the spinal cord, which makes our arms and legs move and feel, is injured, paralysis may occur either with full or partial inactivity and numbness.

Causes

Spinal cord injury and spinal cord paralysis usually occur as a result of injuries caused by traffic accidents and sporting events, falling from heights, and senseless jumping into the sea or the pool. Sometimes, injuries due to attacks and fighting, such as stabbing or bullet wounds, may also be encountered. Other organ injuries associated with spinal cord injury may be life-threatening in such accidents. In these accidents, spinal cord damage and paralysis develop suddenly.

Spinal cord injury may sometimes be due to a hernia, tumor or infection that compresses the spinal cord. In this case, spinal cord damage and paralysis may develop over a long time.

Findings

The patient may have sudden neck, back or lower back pain at the scene of the accident. Patients with sudden spinal cord paralysis cannot move their arms or legs. Similarly, they do not feel underneath the site of injury. There will be no urinary or fecal control. If the respiratory muscles are also paralyzed in the neck fractures, there will be respiratory distress. After the spinal cord is injured, the patient experiences a period of shock that can last from several hours to 6 weeks. It can sometimes be difficult to determine to what extent the spinal cord is damaged during this shock.

Treatment Options

In an accident with spinal cord injury, it is very important to provide emergency response and life support. The patient should be transported to the hospital quickly. The patient should be examined at the accident site and the spine should be immobilized with braces and corsets. If the respiratory muscles are also paralyzed in the neck fractures, there will be respiratory distress. In this case, it may be necessary to ventilate the patient with machines. Therefore, the first response at the scene of the accident is very important. Subsequently, the person injured as a result of the accident must be taken to a well-equipped trauma center.

In addition, new technologies in surgical and medical treatment have led to great improvements in the quality of care, functional recovery, and the survival of the patients.

Is Treatment Possible In Spinal Cord Paralysis?

Spinal cord injury is a complex injury. Here, nerve fibers that come from the brain, pass through our spinal cord and go to our muscles are injured. There is no drug treatment that can easily heal patients admitted to emergency clinics with a spinal cord injury and paralysis. However, there are many chances for intervention that may help these patients recover in the hospital. Quick surgical alleviation of the spinal cord compression with emergency surgery and quick mobilization of patients will contribute to recovery significantly. This healing can be faster, especially if the spinal cord is not fully injured and a timely intervention is performed. Bleeding and swelling into the spinal cord caused by the first impact can also repair itself over time. However, patients should receive good and continuous rehabilitation treatment throughout their lives. With this treatment, patients may even recover years after the injury.

Rehabilitation and Exercise

Patients with spinal cord paralysis may experience complications such as infections, urinary tract problems, progressive deformities in the spine, disruption of spinal cord’s stabilization and chronic pain in later life. Many innovations have emerged in the treatment of spinal cord injury, syringomyelia, treatment of spinal deformities and pain control.

These patients should be under the control of rehabilitation clinics throughout their lives and should not ignore their exercise program and medical follow-ups. Because firstly, exercise and rehabilitation programs cause the release of healing factors in the patient’s nervous system. Secondly, with the exercise and rehabilitation programs, the joints of the patients are forced to be mobile and working. The importance of this, as this is strongly expected one day, is that if a complete cure is found and if the paralysis is cured, the body will be able to move with these healthy joints. Moreover, no one wants to give cellular treatment to a patient whose joints are frozen. The lungs and urinary tract will get better and many infections will be less common with the help of exercise and rehabilitation. It will also be possible to maintain the skin integrity and skin health.

Stem Cell Therapy in Spinal Cord Paralysis

With the developing technology, stem cell therapy, which has become a frequently preferred treatment method in different branches of the field of medicine, has also come into prominence in the treatment of spinal cord paralysis. The purpose of stem cell therapy is to give stem cells to the patient, for these cells to settle in the injured spinal cord region, survive there and to transform into the relevant necessary cells. The ultimate goal is to ensure that the stem cells placed in the spinal cord become functional and that the spinal cord becomes operational again. In this way, the patients will be able to move and feel their arms and legs again and regain urinary and fecal control.

Many centers around the world have been conducting intensive experimental studies, especially for the last 30 years, in order to treat spinal cord injuries. Some of these studies have reached the stage of clinical research. There are some promising works among them. However, none of them have become a standard treatment yet.

Think First

We know that there is no definitive treatment for spinal cord paralysis and it is difficult recover from it. Therefore, all precautions must be taken to avoid injury. Seatbelts should be properly fastened while in traffic and the rules of traffic must be strictly followed. One should not jump into a shallow pool or sea headfirst. Necessary precautions should be taken during sports activities, protective helmets and apparatus should be worn properly and safety must be ensured before jumping from heights.

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