Spinal Cord Injury

Subject: Medical and Surgical Nursing I (Theory)

Overview

Damage to the spinal cord or the nerves at the end of the spinal canal, often known as a spinal cord injury, frequently results in permanent alterations to the strength, sensation, and other bodily functions below the injury site. Any type of spinal cord injury may cause one or more of the following symptoms: loss of movement, loss of sensation, including the ability to feel heat, cold, and touch; loss of bowel or bladder control; pain or an intense stinging sensation brought on by damage to the spinal cord's nerve fibers. Damage to the spinal column's vertebrae, ligaments, disks, or spinal cord itself can result in spinal cord injuries. MRI, CT scan, and x-rays are used to diagnose it. Medications. A therapy option for an acute spinal cord injury is methylprednisolone (Medrol). Those who receive methylprednisolone within eight hours of an injury may notice a slight improvement. Surgery. In order to remove bone fragments, foreign objects, herniated disks, or fractured vertebrae that appear to be compressing the spine, surgery is frequently required. Additionally, surgery might be required to stabilize the spine and stop future pain or deformity.

Spinal Cord Injury

Damage to the spinal cord or the nerves at the end of the spinal canal, also known as a spinal cord injury, frequently results in permanent changes to the strength, sensation, and other bodily functions below the injury site. Recent spinal cord injuries can make it seem as though every aspect of your life will be impacted.

Symptoms

Spinal cord injuries of any kind may result in one or more of the following signs and symptoms:

  • Loss of movement,
  • Loss of sensation, including the ability to feel heat, cold and touch,
  • Loss of bowel or bladder control,
  • Exaggerated reflex activities or spasms,
  • Changes in sexual function, sexual sensitivity, and fertility,
  • Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord,
  • Difficulty breathing, coughing or clearing secretions from your lungs.

Causes

Spinal cord injuries result from damage to the vertebrae, ligaments or disks of the spinal column or to the spinal cord itself.

  • A traumatic spinal cord injury may stem from a sudden, traumatic blow to your spine that fractures, dislocates, crushes or compresses one or more of your vertebrae.
  • A nontraumatic spinal cord injury may be caused by arthritis, cancer, inflammation, infections, or disk degeneration of the spine.

Common Causes of Spinal Cord Injury

  • Motor Vehicle Accidents: Auto and motorcycle accidents are the leading cause of spinal cord injuries, accounting for more than 40 percent of new spinal cord injuries each year.
  • Falls: Spinal cord injury after age 65 is most often caused by a fall. Overall, falls cause more than one-quarter of spinal cord injuries.
  • Acts of Violence: As many as 15 percents of spinal cord injuries result from violent encounters, often involving gunshot and knife wounds, according to the National Institute of Neurological Disorders and Stroke.
  • Sports and Recreation Injuries: Athletic activities, such as impact sports and diving in shallow water, cause about 8 percent of spinal cord injuries.
  • Alcohol: Alcohol use is a factor in about 1 out of every 4 spinal cord injuries.
  • Diseases: Cancer, arthritis, osteoporosis and inflammation of the spinal cord also can cause spinal cord injuries.

Tests and Diagnosis

  • X-rays: Medical personnel typically order these tests on people who are suspected of having a spinal cord injury after trauma. X-rays can reveal vertebral (spinal column) problems, tumors, fractures or degenerative changes in the spine.
  • Computerized Tomography (CT) Scan: A CT scan may provide a better look at abnormalities seen on an X-ray.
  • Magnetic Resonance Imaging (MRI): MRI uses a strong magnetic field and radio waves to produce computer-generated images.

Treatments and Drugs

Early (acute) stages of treatment

In the emergency room, doctors focus on:

  • Maintaining your ability to breathe.
  • Preventing shock.
  • Immobilizing your neck to prevent further spinal cord damage.
  • Avoiding possible complications, such as stool or urine retention, respiratory or cardiovascular difficulty, and formation of deep vein blood clots in the extremities.

Other Treatment Include

  • Medications: Methylprednisolone (Medrol) is a treatment option for an acute spinal cord injury. If methylprednisolone is given within eight hours of injury, some people experience mild improvement.
  • Immobilization: You may need traction to stabilize your spine, to bring the spine into proper alignment or both.
  • 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 future pain or deformity.

Nursing Management

  • Proper immobilization of the neck and back.
  • A cervical collar should be placed.
  • Monitor closely the respiration of a patient, encourage to turn and take a deep breath.
  • Monitor and record vital signs and intake and output, hemodynamic variables, ICP, pulse oximetry to detect early sign pf compromise.
  • Skin Care: turn from side to side , keep clean and dry.
  • Bladder Care: the bladder is atonic during spinal shock bladder retention occurs. After spinal shock client may experience bladder retention, intermittent catheterization is necessary.
  • Positioning and Exercise: maintain proper alignment, prevent foot drop.
  • IV therapy should be initiated.
  • In the acute setting 02 should remain in place.
  • Administer medication as a prescription to decrease pain.
  • Care of Airway, breathing and circulation.
    • Care of Wound : dressing and suturing may be needed.
    • Be alert for a sign of spinal shock and report immediately.
    • Provide constant emotional support.

 References

  • coastalmedicalgroupsd.com/spinal-cord-injury/
  • dolmanlaw.com › Blog › Injuries › Spinal Cord Injuries
  • nmortho.com/spinal-cord-injury-symptoms/
  • philipcaruso-story.com/spinal-cord-injury/
  • prezi.com/c22te5ghd4-h/physical-disabilities/
  • palmettofamilyhomecare.com/specialty-services
  • pharmacypedia.org/diseases-and-conditions/paraplegia-spinal-cord-injury/
  • quizlet.com/43076586/patho-final-flash-cards/
Things to remember

 

  • Damage to the spinal cord or the nerves at the end of the spinal canal, often known as a spinal cord injury, frequently results in permanent alterations to the strength, sensation, and other bodily functions below the injury site.
  • breathing, coughing, or cleaning lungs' secretions with difficulty
  • A quick, severe impact to your spine that fractures, dislocates, crushes, or compresses one or more of your vertebrae can result in a traumatic spinal cord injury.
  • Arthritis, cancer, inflammation, infections, or disk degeneration of the spine can all result in a non-traumatic spinal cord injury.
  • Keeping your neck still to avoid further spinal cord deterioration
  • Turn your head side to side and keep your skin clean and dry.
  • Exercise and positioning help to maintain proper alignment and prevent foot drop.
  • The client may experience bladder retention following spinal shock, necessitating periodic catheterization.
Questions and Answers

Damage to the spinal cord or the nerves at the end of the spinal canal, also known as a spinal cord injury, frequently results in permanent changes to the strength, sensation, and other bodily functions below the injury site. Recent spinal cord injuries can make it seem as though every aspect of your life will be impacted.

Symptoms:

Spinal cord injuries of any kind may result in one or more of the following signs and symptoms:

  • Decline in movement
  • Loss of feeling, including the capacity to experience touch, heat, and cold
  • A lack of bladder or bowel control
  • Hyperactive reflex actions or spasms
  • Modifications to fertility, sexual sensitivity, and sexual function
  • Damage to the nerve fibers in your spinal cord may result in severe stinging or pain.
  • Breathing, coughing, or cleaning lungs' secretions with difficulty

Causes:

  • Spinal cord injuries can be caused by harm to the vertebrae, ligaments, disks, or spinal cord itself.
  • A sudden, traumatic blow to your spine that fractures, dislocates, crushes, or compresses one or more of your vertebrae can result in a traumatic spinal cord injury.
  • Arthritis, cancer, inflammation, infections, or disk degeneration of the spine can all result in a non-traumatic spinal cord injury.

Common causes of spinal cord injury:

  • Accidents with vehicles. More than 40% of all new spinal cord injuries each year are caused by auto and motorcycle accidents, which are the main cause of spinal cord injuries.
  • Falls. After the age of 65, falls are the most common cause of spinal cord damage. Over a quarter of spinal cord injuries are brought on by falls.
  • A violent act. According to the National Institute of Neurological Disorders and Stroke, violent contacts account for up to 15% of spinal cord injuries. These confrontations frequently involve gunshot and knife wounds.
  • Injuries from sports and recreation. About 8% of spinal cord injuries are brought on by athletic pursuits like diving in shallow water and impact sports.
  • Alcohol. About 1 in 4 spinal cord injuries are caused by alcohol use.
  • Diseases. Spinal cord injuries can also result from cancer, rheumatoid arthritis, osteoporosis, and spinal cord inflammation.

 

Treatments and drugs:

  • Early (acute) stages of treatment: In the emergency room, doctors focus on:

    • Keeping your breathing regular
    • Avoiding shock
    • Keeping your neck still to avoid further spinal cord deterioration
    • Avoiding potential side effects like stomach or urinary retention, breathing or heart problems, and the development of deep vein blood clots in the extremities

  • Other treatment include:

    • Medications: A treatment option for an acute spinal cord injury is methylprednisolone (Medrol). Those who receive methylprednisolone within eight hours of an injury may notice a slight improvement.
    • Immobilization: You might require traction to support your spine, align it properly, or both.
    • Surgery: In order to remove bone fragments, foreign objects, herniated disks, or fractured vertebrae that appear to be compressing the spine, surgery is frequently required. Additionally, surgery might be required to stabilize the spine and stop future pain or deformity.

Nursing management:

  • Proper neck and back immobilization.
  • There should be a cervical collar in place.
  • Keep a close eye on a patient's breathing and encourage them to turn over and take a deep breath.
  • To identify early indications of compromise, keep track of your vital signs, your intake and output, hemodynamic variables, ICP, and pulse oximetry.
  • Turn your head side to side and keep your skin clean and dry.
  • The bladder is atonic during spinal shock, which causes bladder retention. The client may develop bladder retention following spinal shock, necessitating periodic catheterization.
  • Exercise and positioning help to maintain proper alignment and prevent foot drop.
  • It is time to begin IV therapy.
  • 02 should be left in place in the acute setting.
  • To lessen pain, administer medication as directed.
  • Breathing, circulation, and airway care.
  • Dressing and suturing may be required for wound care.
  • Watch out for any symptoms of spinal shock and report them right away.
  • Continually offer emotional support.

 

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