Discuss some of the challenges, possibilities and goals for treating spinal cord injuries.
Please include the pros and cons behind treatment options (for example, stem cells as well as the information at the Christopher Reeve Foundation site).
The treatment of spinal cord injury depends upon the number of axons that are damaged during the injury which means that the higher the number of normally functioning axons, the less the amount of disability.
Some patients whose neck area is injured will need help with breathing and require respiratory support via intubation, which involves inserting a tube connected to an oxygen tank through the nose or throat and into the airway.
A steroid drug named Methylprednisolone is used for the treatment for acute spinal cord. It reduces the damage caused to nerve cells and decreases inflammation near the injury site by suppressing activities of immune cells.
Axial Traction which is realignment of the spine using a rigid brace is used to prevent spine damage.
Neurological examination is done to diagnose the severity of the injury which includes X-rays, MRIs, or more advanced imaging techniques.
People with a spinal cord injury will most likely have some medical complications such as:
Injury to the spinal cord at or above the C3, C4, and C5 segments can stop breathing because these supply phrenic nerves which lead to the diaphragm. These people need immediate ventilator support. Injuries at the C5 level and below preserves diaphragm but breathing will become rapid and shallow which lead to coughing and trouble in clearing secretions from their lungs because of weak thoracic muscles. Once pulmonary function improves, patients with C4 injuries can be weaned from mechanical ventilation in the weeks following the injury.
Pneumonia is major cause of death in people with spinal cord injury. Intubation increases the risk of developing a disease known as ventilator-associated pneumonia (VAP) which causes death in patients. Spinal cord injury patients who are intubated should be carefully monitored and should be treated with antibiotics if symptoms occur.
Irregular heart beat and low blood pressure
Spinal cord injuries in the cervical region are often accompanied by blood pressure instability and heartarrhythmias. Because of interruptions to the cardiac accelerator nerves, the heart can beat at a dangerously slow pace, or it can pound rapidly and irregularly. Arrhythmias usually appear in the first 2 weeks after injury and are more common and severe in the most serious injuries.
Low blood pressure also often occurs due to loss of tone in blood vessels, which widen and cause blood to pool in the small arteries far away from the heart. This is usually treated with an intravenous infusion to build up blood volume.
People with spinal cord injuries are at triple the usual risk for blood clots. The risk for clots is low in the first 72 hours, but afterwards anticoagulation drug therapy can be used as a preventive measure.
Many of our reflex movements are controlled by the spinal cord but regulated by the brain. When the spinal cord is damaged, information from the brain can no longer regulate reflex activity. Reflexes may become exaggerated over time, causing spasticity. If spasms become severe enough, they may require medical treatment. For some, spasms can be as much of a help as they are a hindrance, since spasms can tone muscles that would otherwise waste away. Some people can even learn to use the increased tone in their legs to help them turn over in bed, propel them into and out of a wheelchair, or stand.
This solution exemplifies spinal cord injuries. References are also provided to justify the assertions.