Paralysis Resource Guide - (Page 34) CONDITIONS SPINAL CORD INJURY Spinal cord injury (SCI) commonly leads to paralysis; it involves damage to the nerves within the bony protection of the spinal canal. The most common cause of cord injury is trauma, although damage can occur from various diseases acquired at birth or later in life, from tumors, electric shock, poisoning or loss of oxygen related to surgical or underwater mishaps. The spinal cord does not have to be severed in order for a loss of function to occur. In fact, in most people with SCI, the spinal cord is bruised—and intact. Since the spinal cord coordinates body movement and sensation, an injured cord loses the ability to send and receive messages from the brain to the body’s systems that control sensory, motor and autonomic function below the level of injury. Spinal cord injury is an age-old problem but it wasn’t until the 1940s that the prognosis for long-term survival was very optimistic. Prior to World War II, people routinely died of infections to the urinary tract, lungs or skin; the advent of sulfa drugs changed SCI from a death sentence to a manageable condition. Nowadays, people with spinal cord injury approach the full life span of non-disabled individuals. Spinal cord trauma is more than a single event. The initial blunt force damages or kills spinal nerve cells. But in the hours and days after injury a cascade of secondary events, including loss of oxygen and the release of toxic chemicals at the site of injury, further damage the cord. Standard acute treatment for SCI trauma includes administration of the steroid drug methylprednisolone, which if given in the first few hours after injury may limit some of the second wave of destruction. Acute care may involve surgery if the spinal cord appears to be compressed by bone, a herniated disk or a blood clot. Traditionally, surgeons have waited for several days to decompress the spinal cord, since there was some evidence that operating immediately could worsen the outcome. More recently, some surgeons have advocated immediate early surgery. Generally speaking, after the swelling of the spinal cord begins to go down, most people show some functional improvement 34
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