For diagnosing a spinal cord injury the doctor has to get the detailed history of the patient and do a detailed examination to determine the level of injury. This is then confirmed with X rays, MRI and CT scan of the region of suspected injury. Detailed radiological study is needed to confirm the injury and to know the extent of injury. This is necessary to decide the approach towards patient and if surgery is needed, one can plan the surgical approach and type accordingly.
What’s the management of spinal cord injury?
Management is divided in to general condition management and spinal injury management
- General management– Life saving measures – Secure proper ventilation, maintain blood pressure, attain life threatening lung/ abdominal injury.
- Fracture vertebrae / spinal cord injury management – determine whether injury is stable or unstable. If stable, non surgical management in form of rest followed by mobilisation with brace. If unstable injury, it will need surgical stabilisation with or without decompression of neural elements.
- Management of weakness or paralysis – Physiotherapy and rehabilitation with help of physiotherapist and occupational therapists is required. Social and vocational rehabilitation with special efforts is needed to prevent complications like lung infection, pressure sores and venous thrombosis etc.
What’s the prognosis of spinal cord injury?
Prognosis after spinal cord injury depends on – the impact of injury, site of injury, associated injuries, cord status post injury, time lag between injury and start of management, general condition of Patient, age of patient, pre existing medical conditions, medical facilities availability, peri-operative complications, management of spinal cord injury and associated complications.
Poor medical conditions with severe injury associated with dense weakness in all 4 limbs is associated with poor prognosis and relatively high mortality rate specifically if patient has associated difficulty in maintaining blood pressure and has laboured breathing.
Adequate timely resuscitation along with prompt and proper management of spinal cord injury by able team of doctors and paramedics in well equipped centre is essential for improving the prognosis of patient with spinal cord injury.
Family and society support is equally important for proper rehabilitation of patient.