Are you protecting your spinal cord from injury?

Dr H S Chhabra outlines what you must know about your spinal cord and how to protect it.

A column of nerves protected by a myelin sheath, secured by 31 butterfly-shaped vertebrae makes our spinal cord, which literally is the backbone of our physical well-being.

It is susceptible to injuries that can be addressed only through medical intervention.

The spinal cord cannot recover from an injury on its own and repairing spinal cord is a matter of research in many countries.

The most common form of spinal cord injury happens due to trauma.

Road traffic crashes and high falls (fall from balconies/terraces/trees/stairs) are common causes.

Low falls, such as sports injuries or a sudden blow, can also damage the spinal cord.

If a tumor, inflammation or infection compresses the cord, it may also cause an injury; those who have a smaller spinal canal (spinal stenosis) are at a higher risk.

Spinal cord injuries are categorised as complete (absence of sensory and motor function below the site of injury) and incomplete (partial motor or sensory function below the affected area).

Some of the most common partial spinal cord injuries are anterior cord syndrome (affects the front of the spinal cord and damages motor and sensory pathways), central cord syndrome (damages central cord resulting in more weakness in upper than in lower limbs) and brown-sequard syndrome (damages one side of the spinal cord).

These are some common symptoms of spinal cord injury:

• Loss of sensation in the body below the level of injury
• Different degrees of paralysis, including tetraplegia and paraplegia
• Lack of control in bladder and bowel function
• Difficulty in breathing
• Lack of libido or sexual function

Here are a few simple rules that can help you avoid a spinal cord injury:

• Car crashes are one of the most common causes of spinal cord injuries. Seatbelts are as important in the rear seats as in the front. There are special restraints for children.
• Check the depth of the water before diving. Don't dive into a pool that is less than 12 feet (about 3.7 meters) or deep.
• Prevent falls by using a step stool with a grab bar to reach objects at high places.
• Install handrails along staircases and use slip-resistant mats on bathroom tile floors and in the shower.
• While playing sports, always wear the recommended safety gear and avoid leading with head.

Management of spinal cord injury involves a multidisciplinary team approach.

It starts at the site of accident. A trained team should be involved in the evacuation, provision of first aid and then transfer to the nearest facility.

Acute management involves maintaining the oxygen levels in blood to reduce secondary damage to spinal cord, maintained airway and blood pressure and ventilation in high tetraplegics.

The vertebral fractures may be managed by surgery or conservatively depending on the type of fracture.

Comprehensive rehabilitation involves physical, psychosocial, sexual and vocational rehabilitation.

A lifelong follow-up is generally requested.

Dr H S Chhabra is the medical director and chief of spine services at the Indian Spinal Injuries Centre, New Delhi.