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Spinal Cord Injury: Causes And Prevention

spinal cord injuries

5th September is observed as Spinal Cord Injury Day every year with the aim to increase awareness about spinal cord injuries and ways to prevent it as most of the spinal cord injuries can be prevented.

Sanjay, a 30-year-old software employee, was heading to the office on his bike when he met with a road accident. He sustained injuries to his spine and back. He was hospitalized immediately to a nearby hospital. He did not undergo any surgery to repair the fractures. His family was informed that he will not be able to stand or walk in the future. Not just severe spinal injuries, he also lost sensory perception in his hips and legs. He lost control of his bowel and bladder function. It was only after a series of treatment procedures including spine surgery and cell based therapy that he was able to stand and walk.

Spinal cord injury (SCI) is a detrimental health condition that can severely impact the sensory and motor function. It not only affects the individual by negatively impacting the quality of life but also the family and society due to severe economic burden. As there is no curative treatment for the condition, the best strategy is to stay protected from spinal injuries than get it treated. So this World Spinal Cord Injury Day, let’s explore this common and devastating health problems by knowing in detail about its causes and ways to prevent it.

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What Causes Spinal Cord Injury?

Traumatic spinal injury (TSI) means injury to the spinal column, spinal cord, or both. More than 10% of trauma patients sustain spinal injury and they have a higher mortality rate compared to other traumas[1]. According to the World Health Organization, around 250,000 to 500,000 people suffer from a traumatic spinal cord injury every year[2]. This condition can lead to varying degrees of sensory loss, bladder/bowel dysfunction and paralysis. Also, people with spinal cord injury are two to five times more likely to die prematurely[3]. The majority of spinal cord injuries occur between the ages of 16 and 30 with a higher prevalence in men, the ratio of  male-to-female is 4:1[4].

The leading causes of spinal injuries include road traffic accidents, falls and violence. Road traffic and high fall accidents are most common in young patients, whereas low falls and osteoporosis is known to increase the risk of spinal injuries in older people. India is experiencing an increasing trend in injuries particularly due to road traffic accidents at an alarming annual rate of 3 percent[5]. The World Report on Road Traffic Injury Prevention indicates that by 2020, road traffic injuries will be a major killer accounting for half a million deaths and 15 million disability adjusted life years (DALYs) lost worldwide[5]. In India, excessive speed, not using helmets, driving under the influence of alcohol, and poor road design are some of the major risk factors for the increasing number of road traffic accidents[]. The other causes include injuries during sports, domestic violence or assault and certain conditions such as arthritis, osteoporosis and infections such as tuberculosis of the spinal cord.

SCI has been described as developing in three phases: acute, secondary, and chronic[4]. In acute phase, there is a direct mechanical trauma to the spinal cord which causes edema and neural death in the surrounding areas. In secondary phase, ionic changes occur at the site of the injury which causes the release of inflammatory molecules. The third one is the chronic stage which causes chronic pain and spasticity around the injured site.

The symptoms of spinal cord injury can include a partial or complete loss of sensation and mobility of the limbs. It can also affect other parts and organs of the body if the injury involved the nerves that control other bodily functions. This includes systems that regulate the blood pressure,  heart rate, breathing, bowel control and bladder control. 

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Tips To Prevent Spinal Cord Injuries

As road accidents and falls are the key causes of spinal cord injuries, it is important to follow safety guidelines and stay protected to prevent injuries to the spine. Here are a few tips that can help you to prevent spinal cord injuries:

– Never forget to wear a helmet when riding a bike or cycle as the helmet acts as a safety gear to prevent injuries to the head and neck and also lower the impact on the spine. Also, do wear a seatbelt when driving and follow child safety guidelines to prevent injuries.

Never drive when you are drunk because there is a high risk of accident. Also, never ride with someone who is under the influence of alcohol or even drugs as there is a high risk of falling down and injuring the spine in both kids and adults. 

– Always follow the speed limits and traffic rules. Do not use mobile phones when driving and stay away from any distractions when driving or riding.

Wear safety gear when playing sports to prevent any untoward incidents on the ground and stay protected from injuries.

– Check if your home is clean and there is no spillage, especially during rains. Always keep your floor dry as wet floor increases the chances of falls and slips in the house. Also check the same in the office and when walking outside to prevent falls.

Remember spinal cord injuries can significantly impact the person’s physical as well as mental health. Hence, it is wise to prevent these injuries by following simple tips and tricks because PREVENTION IS CURE when it comes to spinal injuries.

(The article is reviewed by Dr. Swati Mishra, Medical Editor)

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References:

1. Birua GJS, Munda VS, Murmu NN. Epidemiology of Spinal Injury in North East India: A Retrospective Study. Asian J Neurosurg. 2018 Oct-Dec;13(4):1084-1086. 

2. Hagen EM. How to prevent early mortality due to spinal cord injuries? New evidence & update. Indian J Med Res. 2014 Jul;140(1):5-7.

3. International perspectives on spinal cord injury. Disability and rehabilitation.

4. Malhotra M, Bhatoe HS, Sudambrekar SM. Spinal Cord Injuries. Med J Armed Forces India. 2010 Oct;66(4):325-8. doi: 10.1016/S0377-1237(10)80009-7. Epub 2011 Jul 21.

5. Lalwani S, Singh V, Trikha V, et al. Mortality profile of patients with traumatic spinal injuries at a level I trauma care centre in India. Indian J Med Res. 2014 Jul;140(1):40-5. 

6. Aleem IS, DeMarco D, Drew B, Sancheti P, Shetty V, Dhillon M, Foote CJ, Bhandari M. The Burden of Spine Fractures in India: A Prospective Multicenter Study. Global Spine J. 2017 Jun;7(4):325-333.

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