The two leading causes of spinal cord injury are motor vehicle accidents and falls, according to recent analysis. A vehicle accident or a fall can damage the cervical, thoracic, lumbar and sacral spine. This damage occurs in two phases: the primary injury and the secondary injury.
Primary and Secondary Injury
Primary injury happens at the time of the accident or fall. For example, in cervical spinal cord compression injury, if the head is pushed too far in any direction, or the spinal cord is over-stretched or squeezed, the nerves may be damaged or torn. The cord may also be cut by fractured bones or by a penetrating object such as a knife. This is a primary injury.
After the primary injury has happened, secondary injury begins. Secondary injury is caused by inflammation, bleeding, cellular changes and bony instability; for example bleeding and swelling put pressure on the spinal cord, and prevent oxygen from reaching the tissues. This causes further damage. Secondary injury begins right after the primary injury, and can last for weeks.
Stabilization to Long Term Management
Initial spinal cord injury treatment stabilizes the primary injury and tries to minimize the amount of damage from secondary injury. Emergency personnel may immobilize the head, neck and back in the field by using a neck brace and strapping the injury victim to a rigid back board. Sedation may also be used to minimize movement. If a spinal injury is found on x-ray, surgery is often the first treatment choice; it provides stability and relieves pressure on the cord.
High levels of steroids have been used in the first hours after injury; however, spinal cord injury research is inconclusive about its overall benefits. Antibiotics, hormones, reducing the body’s core temperature and additional medications may also be used to reduce secondary injuries.
Getting the Best Care
Spinal cord injuries require long term care from a neurologist, rehabilitation doctor, physical therapist, occupational therapist, psychologist, and many more medical specialties. As a lawyer and rehab physician, Dr. Greg Vigna knows what you need to recover, and will be your best advocate.
