Spinal Cord Injury Rehabilitation

What is the Spinal Cord?

The spinal cord is a bundle of nerves that is part of the central nervous system, continuing from the brain and housed within the spine. All the nerves that go to our arms and legs, as well as nerves that control the chest muscles, bladder, bowels, and sexual organs, originate from the spinal cord.

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What Are the Causes of Spinal Cord Injury?

The spinal cord runs through a canal in the spine, extending from the base of the brain down through the neck, back, lower back, and to the tailbone, and is protected by this bony structure. When the spine is damaged for any reason, the spinal cord inside can also be injured, leading to spinal cord injury. The most common cause of spinal cord injuries worldwide and in our country is traffic accidents. Other frequent causes of traumatic spinal cord injuries include falls from height, gunshot wounds, sports injuries, particularly diving into shallow water. Non-traumatic causes can include spinal cord tumors, spinal infections, motor neuron diseases, and disc herniations.

What Are the Clinical Signs After a Spinal Cord Injury?

Different types of paralysis occur depending on the level of injury. This condition is generally referred to as spinal cord injury.

What Are Paraplegia and Tetraplegia?

Tetraplegia occurs when there is motor and/or sensory loss or dysfunction in the arms, torso, legs, and pelvic organs due to injury to the spinal cord within the cervical spinal canal. Paraplegia refers to motor and/or sensory loss or dysfunction in the torso, legs, and pelvic organs due to injury to the spinal cord within the thoracic and lumbar spinal canal.

What Is Complete and Incomplete Injury?

Complete injury occurs when the spinal cord is fully damaged at the level of injury, resulting in total loss of movement and sensation below the injury level, referred to as ASIA A. Incomplete injury occurs when the spinal cord is only partially damaged at the injury level, leading to partial loss of movement and sensation below the injury level, classified as ASIA B-C-D-E depending on the degree of movement.

What Problems Can Be Seen in Patients?

The most significant issue is partial or complete loss of movement and sensation in the muscles below the injury level, depending on the injury level and whether it is complete or incomplete. Nerves going to the bladder and bowels are also affected, leading to problems with sensing or controlling bowel movements and urination, which can result in urinary tract issues and bowel problems. Inadequate bladder rehabilitation can lead to dangerous blood pressure problems, and in the long term, kidney failure. Bedsores can develop due to prolonged bed rest, which are difficult to heal and treat. Lack of muscle and bone use due to immobility can cause muscle and bone wasting, and joint restrictions may develop. Severe and unbearable neuropathic pain and spasms can hinder the rehabilitation process and affect the patient's quality of life. Additionally, sexual dysfunction can also occur in these patients.

Can They Benefit from Rehabilitation?

If the paralysis resulting from spinal cord injuries is complete, unfortunately, it is irreversible. However, in cases of partial spinal cord injuries, partial or full recovery of movement may be seen within a few months or years. Early and quality rehabilitation is essential for preventing the problems mentioned above and ensuring the patient can continue their life independently by making the best use of their remaining functions.

What Is Done in Rehabilitation?

In patients with spinal cord injuries, the goal is to prevent complications and ensure the patient’s independence. The main focus is on trying to regain strength in muscles that have lost strength.

Spinal Cord Injury Rehabilitation

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Conclusion

Rehabilitation programs may include conventional treatment approaches like range of motion exercises, stretching exercises, muscle strengthening exercises, and neurofacilitation techniques, as well as more advanced rehabilitation methods such as robotic rehabilitation, pool therapy, virtual reality therapy, biofeedback, functional neuromuscular electrical stimulation, and transcranial magnetic stimulation techniques. Additionally, the rehabilitation program should include regular bladder and bowel emptying, monitoring to prevent bedsores, using air mattresses and proper positioning, bed exercises to prevent muscle and bone wasting, bringing the patient to an upright position as soon as possible, training suitable patients to walk with devices and external supports, and developing wheelchair transfer skills for those who cannot walk.

Frequently Asked Questions About Spinal Cord Injury Rehabilitation

Can Spinal Cord Injuries Heal?

Most spinal cord injuries are permanent and do not fully heal. However, rehabilitation and treatment can alleviate some symptoms. The degree of recovery depends on the severity of the injury and varies from person to person.

How Do Spinal Cord Injuries Heal?

The treatment process is personalized based on individual needs and may require a multidisciplinary approach. The recovery process varies depending on the patient's condition.

What Is Spinal Cord Injury Rehabilitation?

"Spinal Cord Injury" (SCI) refers to an injury occurring in the spinal cord.

How Long Does It Take for the Spine to Heal?

The healing time for spinal injuries largely depends on the type and severity of the injury and the timeliness of the intervention. It’s important to note that many spinal injuries do not fully heal. The goal is to maintain a quality life for the patient.

Can the Spine Regenerate?

The spine, unlike some other tissues, cannot completely regenerate itself. The spine consists of bones and discs, which can change as they age and heal when damaged. However, they cannot fully regenerate.