Is Spinal Cord Regeneration Possible?

Acute transverse spinal cord injury immediately causes relaxation paralysis below the level of impairment and the loss of all sensory and reflex activities (including autonomic function) (so-called spinal shock). Within hours or days, relaxation paralysis Gradually converted to ankylosing paraplegia, due to the elimination of downward inhibition, the normal tendon stretch reflex appeared to be hypersensitive. Later, if the lumbosacral spinal cord function is intact, flexor spasm may occur, and deep tendon reflexes and autonomic nerve reflexes also recover.

Spinal cord injury

The loss of neurological function after spinal cord trauma is caused by spinal cord concussion if it is relatively short-term; it is caused by contusion or hemorrhage caused by spinal cord compression; the permanent loss of function is caused by spina bifida Injury or transverse injury. In spinal cord contusions, the rapid swelling of the spinal cord and the increase in intradural pressure can cause severe spinal cord dysfunction that can last for several days. Symptoms improved spontaneously in the future, but often left with some dysfunction. Spinal hemorrhage is usually confined to the central gray matter of the cervical spinal cord and produces signs of damage to the lower motor neurons (upper limb muscle weakness with atrophy, muscle bundle tremor, and decreased tendon reflex), and is usually permanent.

Signs and diagnosis of spinal cord trauma

Acute transverse spinal cord injury immediately causes relaxation paralysis below the level of impairment and the loss of all sensory and reflex activities (including autonomic function) (so-called spinal shock). Within hours or days, relaxation paralysis Gradually converted to ankylosing paraplegia, due to the elimination of downward inhibition, the normal tendon stretch reflex appeared to be hypersensitive. Later, if the lumbosacral spinal cord function is intact, flexor spasm may occur, and deep tendon reflexes and autonomic nerve reflexes also recover.

Incomplete damage to the spinal cord causes partial loss of motor and sensory functions. Impairment of voluntary movement. The specific manifestations of sensory disorders depend on the damaged conductive beam: if the posterior column is damaged, it can cause position, vibration, and light touch. Loss of the thalamus of the spinal cord, loss of pain, temperature, and often light or heavy touch Loss of pain and temperature in the lower limbs (Brown-Sequard syndrome). The level of spinal cord injury can be determined based on clinical clues.

Spinal cord injury prognosis

It is impossible to recover completely damaged or degenerated nerve tissue in the spinal cord. Therefore, at least from the current point of view, the functional damage caused is usually permanent. However, animal experimental studies have suggested that contused or severed nerves may regenerate. Compressed nerve tissue can often restore function. If there is an individual movement or sensory recovery within the first week after trauma, it indicates a satisfactory recovery; dysfunction that lasts more than 6 months may be permanent.

Because the lesions of the pony tail are rarely complete, the loss of motor or sensory function is mostly partial. However, if the control is large and the urination function is affected, the reflex arc of the male penile erection and the sexy response of the female (all related to the cone) are destroyed. Reflective urination cannot be established. Trauma to the lumbar or sacral vertebra can damage the pony tail, which may cause permanent impotence and loss of control of the bladder and / or anal sphincter, like the consequences of higher levels of permanent spinal cord injury.

Spinal Cord Injury Treatment

In order to protect the spinal cord from further damage, extreme care must be taken in handling and handling of injured persons with suspected spinal injuries (especially cervical injuries). Unless the extent of the damage is clear, all spinal injuries should be considered as present Unstable phenomenon. If the disc is prolapsed, the ligament is ruptured, or the spine is fractured, flexion or straightening of the spine can cause contusion or transection of the spinal cord. In the process of transporting the injured person, if the spinal cord is not handled properly, the spinal cord can trigger limb paralysis or Death. When moving an injured person who may have a spinal injury, move the entire body together, and place it on a solid, flat wooden board or door panel during transportation, and keep the posture stable with appropriate padding without excessive It is important to maintain the proper curvature of the spine (neutral in terms of anatomical science) by traction. A rigid cervical support should be used to fix the cervical spine. The injured thoracic or lumbar spine can be transported in the prone or supine position. ; Injured patients with cervical spinal cord injury that may induce dyspnea should be placed in the supine position during transport, taking care to keep the airway open and the chest free from Any restriction. Starting to apply large doses of adrenocortical hormone within 8 hours after spinal cord injury can significantly improve the condition. It is recommended to use methylprednisolone 30mg / kg, intravenous infusion for 1 hour, and continue to 5.4mg / kg per hour. The dose is continuously infused for 23 hours.

In the case of spinal stable injuries, treatment includes rest, analgesics and muscle relaxants until swelling and local pain subsides. If possible, it is best to refer the patient to a registered trauma center. For unstable spinal injuries, It is fixed by traction until the bone and soft tissues heal to ensure proper alignment of the vertebrae; occasionally fusion and internal fixation surgery is needed. It is questionable whether surgical decompression is useful for complete lesions; cases of incomplete neurological disorders occasionally after surgery has weakened benefit.

Spinal Cord Injury Care

^[1] Nursing includes prevention of urinary tract infections, lung infections, or bedsores-for example, changing the patient's position every 2 hours (Stryker stent can be applied when needed). Activities for exercise and rehabilitation should be started as soon as possible.

The goal of psycho-emotional care for patients with spinal cord injury is to help patients overcome personality changes and severe depression that is almost inevitable after losing control of the body. Once the patient's mood has stabilized, they should be referred to a rehabilitation center because The staff of the rehabilitation center are more experienced in dealing with the social, economic and employment issues caused by spinal cord injuries and injuries.