All happened so sudden. It happened two years back. A private bus accident changed Jeeja’s life suddenly! Her spinal cord was damaged and she never stood up after that incident. Plus 1 dreams of Arun were clashed he fell from a tall tree while playing. One of his legs was completely paralyzed after this incident. It was a car incident in the case of John. When his jeep fell into a deep valley, his whole body was paralyzed. Though names given for the above incidents are not true, these stories are not fiction. They have occurred in someone’s life suddenly taking each and every colour of their dreams. There is a striking similarity in each and every quoted case – all are related to back bone and spinal cord.

Spinal cord – the main switch

No other accident can leave a person in ventilator or wheel chair for ever, in just one second except damage to spinal cord. It’s the longest nerve of a human body extending from brain to lower end of our back bone. It carries 31 pair of nerves that transmit messages from brain to all parts of our body. Even to move our hands or legs we need messages from brain which are transmitted through our spinal cord. If brain and liver have to function, this spinal cord needs to shower its blessings. It works as an electric main switch of a home. If bulbs of every room needed to be lightened, main switch is to be in ‘on’ position and damage to a particular fuse can damage the lighting system of corresponding part as well.

Spinal cord passes through a canal deeply laid inside the back bone. It’s covered by a group of bones known as spines and is known as back bone. To avoid collision between spines a cushion like factor known as disc is found. Injuries and damages happened to spinal cord are together known as Spinal cord injury. Nerve cells are formed only once and hence, if they are damaged they can’t be replenished. The area where spinal cord is damaged, that corresponding part may stop functioning, similar to the function of an electric switch in a home. It happens when brain messages are not conveyed to that part of the body as spinal cord is damaged.

Most cases are through accidents

Most spinal cord injuries are caused by road accidents – says Indian survey reports. Second chances are falls from heights, may be trees, mountains or buildings. So, 80% of such cases belong to youth, particularly between 16 and 30.

Condition and compression

Spinal cord injury may occur in two ways – condition and compression. In most cases, injuries happen at the time of accident itself. Spikes may be damaged and they penetrate spinal cord causing injuries. It’s known as condition. Sometimes disc may be damaged crushing the spinal cord and this condition is compression. Spinal cord may be damaged or broken in many other ways also.

Spinal cord injury is of two types – either partial or damaged as whole. If it’s fully damaged, the person losses sense of touch and contraction of muscles.

First aid dangers

In rare cases, spinal cord may be damaged after the accident as well. It happens mainly due to the movement of person soon after the incident. If he is not cared properly while lifting or taking him to hospital, movement of back bone may lead to spinal cord injuries. Even a small careless mistake can damage the nerve cells. Normally it’s not possible to detect such damages easily, particularly if persons who are treating him are ignorant of such problems. So, while doing first aid to an injured person, always assume that his back bone and spinal cord is damaged. It helps them to handle him carefully.

Blood pressure of the patient may dip suddenly reducing the blood circulation resulting in injured nerves to damage more. If breathing is not happening properly, less intake of oxygen will decrease lowering of oxygen in nerve cells leading them to death. To avoid such secondary damages, first aid must be given with intense care. First aid is most important for any accident cases and unfortunately, in our country, it’s not given much importance. Also, normal people are not aware of such first aid treatments. Most recently, Highway road traffic patrol and Accident and Trauma centralized functions are activated.

5 First aid rules

• Never carry patient in arms while taking him to a vehicle.
• Never allow the person to move, even if he is conscious. Many injuries may not be visible at first sight. Never allow him to walk, particularly if he says, he has pain in neck or chest.
• Carry him like a log while transferring to a vehicle. Give support to whole body, not only legs and hands. Give him good support to back and never move his body parts too much.
• Giving water or food may harm later.
• If breathing problems occurred to a person wearing helmet, give him support beneath his neck using both the arms without giving any movement. Another person can remove the helmet. Take care of his nose also, while removing.

Closely watch the symptoms

When the injured person is taken to hospital, he often complains about back pain, chest pain, pain around neck etc. In some persons, breathing problems are noticed while some others find difficult in moving body parts. These are the common symptoms of spinal cord injuries. If he lies abnormally or he feels loss of strength of body parts or sense of touch, they may be indicators of spinal cord injuries.

How treatment is conducted?

As soon as he reaches hospital, doctors ensure if he is getting enough breathing air and if his blood circulation is ok. Then first stage check is done to determine the type of wound and position. Next stage is the expert opinion. Image processing methods like scan are used to detect wounds of spinal cord. Earlier X-rays were used for this purpose. But X-rays have some limitations; they can’t penetrate inside back bones. Also minor fractures can’t be detected. So CT scans and MRI scans are used for this purpose. Most recently spiral 3D CT scanners are used to get three dimensional pictures.

How much damage has happened and exact locations of fractures can be known well through 3D scans. Taking intensity of injury, location in spinal cord, nerves etc are the factors that determine the future of patient.

According to injuries of body parts, spinal cord treatment is categorized into three – neck, chest and back bone. Most serious are wounds happened in neck position, as nerves needed for proper respiration passes through neck. If wounds are related to upper part of back bone or regions near brain, it may adversely affect body movements or sense of touch. 

Paralysis of three types

Cervical injury – All body parts below neck are paralyzed. It’s also known as quadriplegia.
Thoracic injury – Chest and below parts may be paralyzed. It’s known as paraplegia. 
Lumbar injury – Waist and below parts may be paralyzed. It’s also known as paraplegia. 

Can he walk?

60-70% persons can be completely cured with the help of medical aid and he can walk. But, if his spinal cord is broken or completely crushed chances are remote. It injury is partial, a particular body part may be affected. That’s the reason why, after an accident a person become paralyzed by a hand or leg. But his memory and brain functions work perfectly ok. Only a particular body part losses its ability to move. Through Neurology –Neuro-physiotherapy team work, he can continue his life making use of his paralyzed body parts. We can find many such persons in real life – from Christopher Reev to Simon Brito.

When is surgery needed?

For those persons who didn’t get major spinal cord injuries during accident, we have hopes. Defects of back bone can be treated effectively using surgical methods. Main aims of surgery are as follows.

First one is decompression laminectomy where pressure on spinal cord is reduced through surgery. For this, fluids, tissues, broken bone parts, broken disc parts, particles etc that are causing troubles to spinal cord are removed.

Second method is to restore backbone strength. Those broken bones are joined again and dislocated ones are relocated using metal rods, plates and screws. Even if the victim losses some bones during accident, it’s possible to take bones from his hip to give him a new life.

Earlier, open surgeries were conducted. Now time has changed giving rising to less complex, microscopic surgeries. Steroids are given if swellings present. After surgery, next step is rehabilitation. Physiotherapy is most used for this purpose, thus increasing the functioning and movement of body parts as whole.

From stem cells to bacterial enzyme – to restore nerve cells

If spinal cord gets damaged permanently, what’s the next step? No reasonable answer till now. Still researches are going on to find methods to restore those damaged nerve cells. There is a provision to freeze spinal nerve, systemic hypothermia to reduce damages. This treatment is successful in animals. Cell grafting, above and below those damaged parts of spinal cord is also being experimented. Schwann cells of skin surface that can detect smell are used for this purpose. Stem cell treatment using embryo cells exists, but still under experimental stage. Bacterial enzyme is another discovery that can block proteins that reduces nerve cell growth.

Though many technologies have been developed, man is still defeated before the defects of spinal cord. Though many treatments can improve the health condition of the patient, permanent ‘get up/stand up’ of the patient is still to be found. Only remedy is not to lose heart with the disaster. Instead, make those defects a weapon to fight against life. You can even imagine the power provided by your mind to get over those difficult situations. Good rehabilitation programs, new instruments, physiotherapy treatments, all these techniques will be effective only if your mind is determined so!