Traumatic spinal cord injury (TSCI) is associated with damage to the spinal bones. According to statistical data, every year, this type of injury accounts for 40-80 cases per million population (World Health Organization). The most common causes of TSCI include traffic accidents, falls from the height (including suicide attempts), degeneration due to disease, and so on (World Health Organization). Other common causes may also include medical errors committed during operations on the spine or traumas due to sharp turns of the head.
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Types of TSCI
TSCIs are divided into two major groups: incomplete injury and complete injury (“Spinal Cord Injury”). The former refers to an injury that does not impair the functions of the spinal cord or causes only a partial functional impairment, while the latter implies the injury causing the complete rupture of the spinal cord. The incomplete injuries are most common. They comprise up to 60 percent of all TSCI cases (“Types of Spinal Cord Injuries”). The most common types of partial injury are anterior cord syndrome, central cord syndrome, and Brown-Sequard syndrome.
XII thoracic and V-VI cervical vertebrae are exposed to accident-associated TSCI most frequently and usually lead to fatal cases, while the lumbar − the least (Zulkipli et al. 6). These findings support the assumption that “the higher the injury occurs, the more severe the damage” may be (“Spinal cord injuries” par. 1). Even with minor spine injuries, the irreversible impairments of the spinal cord can be developed and, with more severe traumas, especially those associated with the narrowing of the spinal canal, the possibility for the severe brain damage increases (Hsiang 1). At the same time, damage to any section of the spinal cord may affect individuals’ sensory, motor, and reflex abilities.
The types of complete TSCI are tetraplegia, paraplegia, and triplegia (“Types Of Spinal Cord Injuries”). Immediately after the trauma, deep dynamic disturbances occur in the nerve cells and, due to this, their functioning becomes disrupted. In other words, the body becomes paralyzed starting from the location of the fracture and below. As a rule, the duration of a spinal shock depends on the severity of the injury. However, at the initial phase of all TSCIs, the picture of the spinal shock is identical, and it may largely complicate the diagnosis.
TSCI is associated with hematomyelia − “intramedullary hemorrhage, which can extend over several spinal cord segments” (Rosman and Harini par. 6). This phenomenon is very destructive and most frequently occurs at the level of the cervical and lumbar thickenings. Its symptoms can manifest right after the injury and, as the bleeding increases, they can progress for several hours. One of the important symptoms of hematomyelia is the dissociated sensitivity disorder which implies the preservation of deep sensitivity and the loss of surface sensitivity. When the anterior ligaments of the spinal cord are affected, peripheral nerve paralysis can be observed (Rosman and Harini).
The success of intervention largely depends on such variables as the level of injury severity, types and degree of consequent impairments, the overall condition of the individual’s health, and the availability of various sources of support (e.g., family) (“Spinal Cord Injury”). The therapy usually includes activities aimed at the development of mobility, socialization and communication skills, as well as physical care and psychological counseling. The ability to address both physiological and psycho-emotional needs of patients with TSCI may largely determine whether it is possible to assist him/her in returning functionality and independence.
Hsiang, John. “Spinal Stenosis Clinical Presentation.” Medscape. 2017.
Rosman, Paul and Chellamani Harini. “Spinal Cord Injury.” iKNOWLEDGE. 2015.
“Spinal Cord Injuries.” SpinalCord.com.
“Spinal Cord Injury.” Johns Hopkins Medicine.
“Types of Spinal Cord Injuries.” SpinalCord.com.
World Health Organization. “Spinal Cord Injury.” WHO, 2013.
Zulkipli, Zarir Hafiz et al. “Spine Injuries among Fatal Victims of Vehicular Accidents in Kuala Lumpur, Malaysia.” IRCOBI Conference, 2012.