Spinal cord injury (SCI) is a significant medical condition that affects a large number of individuals, particularly in the United States. With an estimated 250,000 to 400,000 people living with SCI, it is a condition that predominantly impacts those who are 30 years old or younger. The causes of SCI are usually traumatic, leading to various degrees of damage such as contusions, partial tears, or complete transections of the spinal cord.
Respiratory dysfunction and associated diseases are prevalent comorbidities, especially in cases of cervical and higher thoracic injuries. The mechanisms underlying these complications can vary based on both the level and the chronicity of the injury. For example, descending sympathetic inhibitory signals originating above T6 cannot traverse the injury zone, leading to sustained hypertension until noxious stimuli are withdrawn. This highlights the complex interplay between the injury site and the body’s response mechanisms.
The management of SCI involves a comprehensive approach, addressing issues like paralysis, spastic hypertonia, and central pain syndromes. A typical medication strategy might include a maximum dose of 3600 mg, divided into three or four daily doses. For conditions like autonomic dysreflexia in patients with spinal lesions at or above T6, topical anesthetic gels are recommended during bowel programs.
A deeper understanding of spinal cord impairments and functional goals is essential for effective management. This is highlighted in a 26-minute video that offers insights into the normal function of the spinal cord and the impacts of impairment at various levels. Setting functional goals for different levels of impairment is crucial for patient recovery and rehabilitation.
Symptoms of SCI can vary depending on the injury’s location. For example, a cervical herniated disc may exert pressure on a cervical spinal nerve, causing pain, pins and needles sensations, numbness, or weakness in the neck, shoulders, or arms.
For more detailed information on spinal cord injuries and their management, refer to the following resources:
Guidelines for SCI Respiratory Management
Spinal Cord Injury Services at URMC
Guidelines for Upper Limb Function Preservation in SCI
Medical Management of Spasticity in SCI and TBI
Guidelines for Managing Autonomic Dysreflexia in SCI
Guidelines for Neurogenic Bowel Management in SCI
Expected Recovery Following Spinal Cord Injury
Understanding Herniated Discs: Cervical, Thoracic, Lumbar
