Spinal cord injury (SCI) is one of the most serious consequences of high speed accidents or sports injury, but devastating, rarely can also occur after infections, tumors or ischemic injury. The largest risk group are younger people because of their propensity to perform risky activities but a person of any age can suffer from SCI. Car and motorcycle accidents are mostly injuries and complicated picture after this injury a multi-disciplinary team of professionals is vital to make certain the patient achieve the highest level of independence for their particular condition. Quadriplegia and paraplegia terms are used to describe disability.
Medical emergency situation is dealt with first, keeping the person alive and ensure their breath is clear. Once in hospital doctors test the patient to find out what was damaged spinal level as this determines much of physiotherapy and medical management. Low spinal injuries such as lower back will have no consequences for the patient's ability to breathe and have good arm and trunk power to work on independence. A thoracic or cervical injury paralyzes large part of rib muscles, reducing spontaneous breathing ability and power limitation arm, making rehabilitation more difficult.
First thing to establish is the level of injury, a diagnosis that is very important as it indicates the whole path of medical and physiotherapy management. If the spine is fractured lower back should be few, if any, respiratory consequences and the patient will have full strength in his arms and chest to achieve independence. If the damage is big in the chest or throat, this may compromise the patient's ability to breathe spontaneously and will mean a more difficult period of rehabilitation with complete independence limited.
Transfer the patient to the intensive care ward following the period and should be stable now medical. The patient may undergo spinal fusion surgery with internal fixation to stabilize the fractured segments, avoiding the need to wait the typical healing period spine, which is three months. Now the patient can begin early rehabilitation with tight control over the respiratory capacity of the patient physiotherapist, exercise non-paralyzed areas for strength and mobility and carrying out passive movements regular paralyzed limb to preserve and increase the ranges of motion. If the spine is unstable
, which is usually the cause paraplegia spinal trauma, spinal surgeon will stabilize the spine, usually with instruments and bone grafting. This allows the patient to start their rehabilitation without the long wait for vertebral fractures to heal naturally. Initial physiotherapy management is to monitor respiratory status, encourage active movement of unaffected areas and perform passive movements of paralyzed body parts to retain and improve ranges of motion that will be needed later for independence. The physiotherapist will progress gradually
Patient in a vertical position by putting up the back of the bed. If it rises too fast, the patient's blood pressure may drop suddenly and this must be avoided so that the patient is eventually transferred to a wheelchair with a sloping back and elevating leg rests. Gradually they become more upright and can start practicing sitting balance on a pedestal and is usually poor trunk control and must be mastered before arm and trunk strengthening and wheelchair transfers can be practiced safely.
Next stage of rehabilitation involves getting the patient to a wheelchair, but the patient's baseline blood pressure may react badly to fall heavily so they are settled gradually into bed and then transferred to a seat back on a slope and with lifting leg rests. Tolerance to be upright and standing balance is gradually expanded practiced on the edge of a plinth with physiotherapist closely monitor any poor trunk control. Physiotherapist will take steps to strengthen and teaching transfers in a wheelchair and once the patient has developed balance meeting reasonable and is used to transfer and be in a wheelchair for extended periods of time, it needs to be transferred to a spinal injuries unit where they can get professional help from a multi-disciplinary team for many aspects of their condition they need to master to be as independent as possible.
Category: Healthcare Basics