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Spine Injury Tips

Minimally Invasive Spine Surgery - Who Should Actually Go For It?

Dr. Saravanan Manoharan 88% (10 ratings)
MS - Orthopaedics, MBBS
Orthopedist, Chennai
Minimally Invasive Spine Surgery - Who Should Actually Go For It?

The spine plays a very crucial role, both from a person’s movement and sensation point of view. It carries the nervous supply for a lot of internal organs and the lower body. By virtue of its structure, it also helps in movement through the disks. Due to various reasons, spinal injury is common, causing pain along the back, lower extremities, neck etc.

Medicines and exercise are the first line of treatment for most spinal injuries. The issue, however, is that these only provide relief from the pain and the medicines, but do not actually ‘rectify’ the underlying problem. Whether it is a herniated disk or a pinched nerve, the medicines and exercise can relieve the symptoms, but the disk continues to be herniated and the nerve continues to be pinched. Definite treatment is in the form of surgery, and with recent advancements in the field of spinal surgery, there are minimally invasive surgical options, which provide complete cure with minimal recovery time. Some of the benefits of this are listed below-

  1. Smaller incision compared to traditional surgical procedures, where only the injured area is accessed

  2. The surrounding tissues are untouched, unless they are injured and require repair

  3. Lesser bleeding compared to earlier techniques

  4. Lesser painful procedure

  5. Reduced hospitalization period

  6. Quicker recovery and return to normal activities

The question, however, is whether this is indicated in everybody. A detailed discussion with your surgeon keeping the below points in mind will help identify the answer for this. The main driver should be the answer to the question – will the surgery be able to effectively relieve you of the pain and symptoms? Additionally, the following factors help in getting better results out of a minimally invasive spinal surgery.

  1. Presence of symptoms relating to nerve compression, including pain from the spine down the leg.

  2. Recent onset of symptoms, with pain starting days to months before seeing the doctor. This indicates the condition is relatively new and so damage is minimal, indicating favorable outcome. Chronic pain conditions take slightly longer time compared to recent injuries.

  3. People with active lifestyle who engage in regular physical exercise are likely to have better benefits from the minimally invasive procedure.

  4. Smoking reduces blood flow to the spine, leading to disk degeneration and weakening of bones. Healing is highly slowed down and recovery is overall delayed.

  5. Excessive weight puts strain on the back, and so healing can be delayed or badly affected with more complications. It is not a contraindication, but be prepared for a longer recovery period.

Talk to your doctor keeping these points in mind, and you can bid farewell to your back pain forever.

1 person found this helpful

Spinal Cord Injury Prevention - Know What Can Be Helpful!

Dr. Ravindra Srivastava 91% (17 ratings)
M.Ch, MS, MBBS
Neurosurgeon, Greater Noida
Spinal Cord Injury Prevention - Know What Can Be Helpful!

A spinal cord injury is a damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.

The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.

If the spinal cord sustains an injury, some or all of these impulses may not be able to ‘get through’. The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

Causes-

A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:

  • a violent attack such as a stabbing or a gunshot
  • diving into water that’s too shallow and hitting the bottom
  • trauma during a car accident (specifically, trauma to the face, head and neck region, back, or chest area)
  • falling from a significant height
  • head or spinal injuries during sporting events
  • electrical accidents
  • severe twisting of the middle portion of the torso

Symptoms

Some symptoms of a spinal cord injury include:

  1. Problem in walking
  2. Loss of control of the bladder or bowels
  3. Inability to move the arms or legs
  4. Feelings numbness or tingling in the extremities
  5. Unconsciousness
  6. Headache
  7. Pain, pressure, stiffness in the back or neck area
  8. Signs of shock
  9. Unnatural positioning of the head

If you suspect that someone has a back or neck injury:

  • Don’t move the injured person – permanent paralysis and other serious complications may result
  • Keep the person still
  • Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives
  • Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck

Prevention-

Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk.

 Some risk-reducing measures include:

  1. always wearing a seatbelt while in a car
  2. wearing proper protective gear while playing sports
  3. never diving into water unless you’ve examined it first to make sure it’s deep enough and free of rocks

In case you have a concern or query you can always consult an expert & get answers to your questions!

1859 people found this helpful

Spinal Cord Problems - How Pain Management Therapies Can Help?

Dr. Amin A. Khan 90% (271 ratings)
MDT(Mc Kenzie) , P.G-Dietitian, N.D.T-( Neuro Development Technic ), Physiotherapist
Physiotherapist, Mumbai
Spinal Cord Problems - How Pain Management Therapies Can Help?

If oral medications are not proving helpful in managing pain for injuries related to the spinal cord, then one must try for pain management therapies as nowadays, they are highly recommended by the doctors. There are three different types of therapies that can reduce pain without the intervention of a surgery

These therapies are provided on a trial basis and if a person responds to any of the trials, then long-term treatment plan is decided by a physiotherapist along with a neurologist. While implantable pain management might not work for everyone, if it does, a person might experience a significant reduction in pain.

Peripheral nerve stimulation and spinal cord stimulation to counter the pain:
Both Peripheral nerve stimulation and spinal cord stimulation are types of electrical stimulation that can be deployed to treat chronic pain.
This is a method wherein, insulated wires that have electrical contacts are inserted near the spinal cord. In case of the peripheral nerve stimulation therapy, the wires are placed beneath the skin. An implanted generator is attached to a wire, in order to send electrical pulses around the affected area of the spinal cord.

During the process of implantation, a patient is awakened, so as to understand whether the pulse is being directed to the right spot or not and also if there is any relief from pain or not. In some cases, patients may need both peripheral nerve field therapy and spinal cord stimulation at the same time. Stimulation does not necessarily eliminate the pain altogether, it, however, can reduce the pain to half, thereby leading to drastic improvement in performing daily activities.

Intrathecal Pain Pump
This is a procedure through which medication is directly delivered to the spinal cord by implanting an intrathecal pain pump. The medication is directly sent to the pain receptors, thereby ensuring that the brain doesn’t get the pain reception from the neuron. This helps in easing the perception of pain.

This is a procedure where a person is given a general anesthesia only to insert a thin catheter into the fluid-filled region of the spinal cord known as the intrathecal space. A doctor implants a small pump in the abdomen and the same is attached to a catheter. This is followed by injecting the medicine into the reservoir of the pump. In these cases, strong painkillers such as morphine are injected into the pumps, these are filled with painkillers once in a month. This mode of treatment is helpful owing to the act that the body has round-the-clock medication at its disposal. There is provision to administer multiple medicines in case of serious pain. Doctors try to target the exact location of the delivery so that small dosage of medicine can relieve the pain without side-effects.

Spinal Cord Injury - Are You Aware Of The Signs?

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Spinal Cord Injury - Are You Aware Of The Signs?

A spinal cord injury is a damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.

The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.

If the spinal cord sustains an injury, some or all of these impulses may not be able to ‘get through’. The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

Causes-

A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:

  • A violent attack such as a stabbing or a gunshot
  • Diving into water that’s too shallow and hitting the bottom
  • Trauma during a car accident (specifically, trauma to the face, head and neck region, back, or chest area)
  • Falling from a significant height
  • Head or spinal injuries during sporting events
  • Electrical accidents
  • Severe twisting of the middle portion of the torso

Symptoms-

Some symptoms of a spinal cord injury include:

  1. Problems walking
  2. Loss of control of the bladder or bowels
  3. Inability to move the arms or legs
  4. Feelings of spreading numbness or tingling in the extremities
  5. Unconsciousness
  6. Headache
  7. Pain, pressure, stiffness in the back or neck area
  8. Signs of shock
  9. Unnatural positioning of the head

If you suspect that someone has a back or neck injury:

  • Don’t move the injured person – permanent paralysis and other serious complications may result
  • Call 911 or your local emergency medical assistance number
  • Keep the person still
  • Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives
  • Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck

Prevention-

Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk.

 Some risk-reducing measures include:

  1. Always wearing a seatbelt while in a car
  2. Wearing proper protective gear while playing sports
  3. Nver diving into water unless you’ve examined it first to make sure it’s deep enough and free of rocks

In case you have a concern or query you can always consult an expert & get answers to your questions!

2 people found this helpful

Spinal Cord Injury - Tips To Help You Recover!

Dr. Pradyot Kumar Govil 88% (10 ratings)
MBBS, MS - General Surgery, Mch - Neuro Surgery
Neurosurgeon, Ghaziabad
Spinal Cord Injury - Tips To Help You Recover!

A spinal cord injury involves damage to the spinal cord either from trauma, loss of the normal blood supply, or compression caused by a tumor or infection. These injuries can either be complete; wherein there is a complete loss of sensation and muscle function in the body, below the level of the injury or incomplete; wherein there is some remaining function below the level of the injury. In most cases, both sides of the body are affected equally.

Classification of the spinal cord injuries

  • High-cervical: It involves the topmost vertebrae in the spinal column, which can result in partial or full paralysis if the spinal cord is severed.
  • Low-cervical: Damage to this area can affect the function of the upper limbs.
  • Thoracic: It involves the center of the spinal column; damage to this area can impact the muscles and nerves of the trunk.
  • Lumbar: It is the commonest site of lower back pain; damage to this area can affect the lower back and limbs.
  • Sacral: Any trauma to the tailbone can cause damage to the nerves in the sacral part of the spine.

Several cases of spinal cord injury are treated with surgery. The two major goals of surgery involve relieving the pressure on the spinal cord and stabilizing the spine.

Quick recovery from spinal cord injuries

Damage to the spinal cord often causes inflammation of the surrounding tissues. A smooth and quick recovery can be achieved by promptly addressing the inflammation post-injury. Following tips can help regain a normal range of motion, promote fast healing, and eliminate pain:

  • Cold therapy: One of the best ways to treat inflammation is with cold application. The lower temperature causes constriction of blood vessels, which reduces the flow of blood to the injured area and helps control swelling. Additionally, a reduced body temperature around an injury slows down cellular metabolism and cell death, minimizing the amount of tissue repair required. Also, pain reduction by a brief deadening of nerve endings and lessening sensation in the affected area is achieved with cold application.
  • Ample rest: Overexertion has to be avoided during the recovery period to ensure that the body gets a lot of rest. Adequate rest needs to be supplemented with a healthy diet to provide the body with all the nutrients it needs for healing.
  • Physical therapy: Physical therapy is an important component of fast recovery in a spinal cord injury. Gentle strengthening and stretching exercises will help an individual regain range of motion, improve flexibility, and build the surrounding muscles to support the spine. It is advised to work closely with a physical therapist and follow their instructions for better results.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3084 people found this helpful

5 Exercises That Can Keep Your Spine In Perfect Shape!

Dr. Aamir Kaleem 88% (10 ratings)
M.P.T, Bachelor of Physiotherapy
Physiotherapist, Bangalore
5 Exercises That Can Keep Your Spine In Perfect Shape!

Spinal cord is a very important part of your body as it renders support to your body.  It also gives your body a good posture and thus, maintaining a healthy spine is very essential. An unfit spinal cord can lead to various complicated problems. The following are five must do exercises in order to maintain a healthy spine:


1. Exercising your core muscles can help you to maintain a fit spine. Your core muscles refer to the muscles of your lower back and your abdominal muscles. These muscles give support to your spine. So exercising them can give you a healthy spine.


2. Walking regularly can also give you a healthy spine. It is suitable for people of all age groups. Daily walking can help you to recover from various spinal illnesses as well such as spinal stenosis.


3. Swimming is also good exercise for maintaing a fit spinal cord. Swimming helps to exercise all back muscles and thus, gives you a healthy spinal cord.


4.  Lying down straight with your face down on an even and firm surface for about twenty minutes can help you to get a healthy spine and also a good body posture.


5.  Cycling can also help you achieve a healthy spine. While cycling, all your back muscles and the muscles of the lower part of your body are engaged in physical activity. If the muscles of your lower back are strong, then it can help you to keep your spine fit.


Other than these exercises, stretching your limbs and other stretching exercises are also beneficial for a healthy spine. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

2041 people found this helpful

5 Physiotherapy Exercises For Spinal Cord Injury

Dr. Vishwas Virmani 91% (20373 ratings)
MPT, BPT
Physiotherapist, Noida
5 Physiotherapy Exercises For Spinal Cord Injury

1.Maintaining Passive and Active Range of Motion

The patient’s lower limb should be moved passively by the therapist through full range of motion if the patient is not able to perform the movement actively. Wherever the patient is likely to put his active efforts to perform the movement, the therapist should encourage it as this will not only maintain the active range but will also help the patient to maintain the properties in his muscles. 

Passive movements need to be given every two hourly hence the patient’s relative attending him should be taught the correct way of handling and giving passive movements without producing undesired movement of the spine.Passive movement helps to maintain the normal physiological length of soft tissues and prevents tightness. 

It maintains the memory of the movement pattern in brain which may help in the later stages of recovery. Passive movements also help in reducing spasticity if given in a gentle, slow and rhythmic manner.Along with passive movements, all the biarticular muscles of the lower limb should be stretched.

2.MAINTENANCE OF GOOD BRONCHIAL HYGIENE 

As the patient is totally bedridden it leads to deconditioning of the respiratory system. Moreover in higher cord lesion due to respiratory muscle weakness, the patient needs ventilatory support which further increases the chances of lung infection. Hence proper lung hygiene should be maintained by given proper positioning, nebulization and regular suctioning. If the patient is not on ventilatory support then he should be taught 

3.BREATHING EXERCISES and encouraged doing it every hour. 

4.ACTIVE EXERCISES 

As soon as the patient shows signs of active contraction of muscles and active participation, all the exercises that needs active cooperation of the patient should be started. These exercises are essential to make the patient functionally independent. The common exercises which are incorporate into the treatment program consist of Mat exercises, strengthening techniques, weight bearing exercises, normalizing tone in the lower limb, gait training and transfer activities.

5.MAT EXERCISES

To prepare the patient for gait training and erect posture mat exercises play a very important role. These exercises consist of those activities that may help the patient to achieve some functional independency. 

The activities consist of turning to each side, rolling and bridging. Similarly in prone position the patient may be given activities such as coming on to the forearms,coming on to extended forearms, quadripedal position with the help of some external support, kneeling with support, half kneeling etc.

2 Physiotherapy Exercises for Spinal Cord Injury

Dr. Vishwas Virmani 91% (20373 ratings)
MPT, BPT
Physiotherapist, Noida
2 Physiotherapy Exercises for Spinal Cord Injury

A.STRENGTHENING EXERCISES:

These consist of exercises to strengthen the lower limb muscles in case of lower motor neuron type of palsy. Strengthening of the upper limb is essential as this will help the patient to enable efficiency in activities like transferring,use of walking aids like crutch, and also helps in over all functional rehabilitation. Strengthening of trunk muscles is essential for better trunk control and stability which will help in better balancing in sitting or standing.

 Quadratus lumborum is the most important trunk muscle in case of spinal cord injury that has got no hip flexors because it enables the patient to hike the pelvis.

Use of tilt table: In the initial stages when there is no trunk stability patient can be trained for weight bearing on lower limbs by using tilt table.In this the patient’s trunk and the lower limbs are strapped to the tilt table and then the table is tilted such that the patient is in erect position.Moreover tilt table can also be used in the initial stage to prevent the chances of orthostatic hypotension

For preventing hypotension in the initial stages the patient is made to lie on the tilt table and the table is gradually tilted everyday at increasing range so that the autonomous nervous system is made to get conditioned as a result the reflex vasoconstriction can bestimulate d in erect position. This will help in preventing or treating orthostatic hypotension.

Transfer activities: To make the patient independent in ADL, it is necessary to train him to use the wheelchair. Easy ways of transfer from bed to wheelchair from wheelchair to low stool and from low stool to floor and back to wheel chair should be taught to patient. The patient also should be trained for balance in sitting position if his trunk muscles are also affected. Patient should also be taught various ways of locomotion in emergency situation like shuffling in sitting position, semi crawling in prone position with the help of weight bearing on the forearm.

B.GAIT TRAINING:

Spinal cord injury can be made to ambulate with the help of crutches and calipers. There are various types of gait that can be taught with the assistance of axillary crutches like shuffling gait, dragging gait and swing gait. However walking should be trained in a gradual manner. The lower limbs are supported with appropriate orthosis and the patient is made to sand in the parallel bar. The patient is advised to do hyperextension at the hips and trunk to maintain erect posture and balance. 

Hyperextension of the hip locks the hip with the help of ischio-femoral ligament and thus provides stability. Once the patient is confident in standing gait training is started by instructing the patient to lift one leg and take weight on other extremity. Stepping forward is taught next and the physiotherapist progresses to walking in parallel bars.After this patient is made to walkout of the parallel bar with the help of walker.Depending on the trunk stability and confidence of the patient progression can be made to axillary crutches. Elbow crutches or canes can be given only if the upper limb musculature becomes quite strong to weight bear efficiently and within the safely limit of the patient. 

Even if the patient is not going to be a community walker, it is important to give him gait training so that can achieve some independency in activities of daily living and to maintain his self-esteem. Weight bearing on the lower limbs in erect posture also acts to slowdown the process of osteoporosis and prevent tightness.

Use of orthosis or appliances: lower limb orthosis or gaiter may be used depending on the muscular status in the lower limbs. 

Keep Your Spine Safe - Spinal Cord Injury Has Lot Many Complications

Dr. Vishwas Virmani 91% (20373 ratings)
MPT, BPT
Physiotherapist, Noida
Keep Your Spine Safe - Spinal Cord Injury Has Lot Many Complications

SPINAL CORD INJURY

Mechanism of the injury that can cause damage to the vertebrae with a resultant damage to the cord is usually a hyper flexion with rotation is less likely to cause damage to the cord.Injuries to the spinal cord can be caused by:

  1. Fracture or fracture  with dislocation  
  2. Sports injuries 
  3. Industrial injuries 
  4. Stab injury 
  5. Gunshot injuries 
  6. Surgical procedures:     surgeries done in and around the spinal cord can cause damage to it.Fracture or fracture dislocation can be caused either due to collision of a heavy object over the head or directly over the spine.

COMPLICATION OF SPINAL CORD INJURIES 

Pressure sores: In case of chronic illness with spinal cord injury, the patient is bed-ridden for a long time. If proper care is not taken patient develops pressure sores which becomes a major complication if infected.

Tightness and contractures: because of inability of the patient to move the lower limbs, patients lower limbs are positioned under the effect of gravity or under the influence of spasticity. The patient suffers from tightness, contractures and loss of ROM. If these are not treated in time it will lead to fixed mal   alignment of joints which eventually will lead to deformity.

Osteoporosis: without adequate weight bearing imposed on the lower limb bones more and more calcium is released from bones which causes osteoporotic and fragile bones that is prone to have fractures even with trivial trauma.

Urinary Tract infection and urinary calculi: due to urinary retention in the spinal cord injury patient there is growth of bacteria primarily due to the presence of an indwelling catheter which acts as a main source of entrance for the bacteria.

Pain syndrome: the source of pain can be traumatic, spinal cord pain and musculoskeletal.

PHYSIOTHERAPY MANAGEMENT

The aims of the physiotherapy management consist of:

  • Prevention of all   secondary complications as a result of being bedridden. 
  • Restoration of   functional independency to the maximum possible limit. 
  • Psychological  counseling. 
  • Social and vocational  rehabilitation.
  • Family education   
  • Home adaptation.

How To Deal With Spinal Stenosis?

Dr. Shobhit Tandon 88% (506 ratings)
MBBS, PG-Diploma In Clinical Pathology
General Physician, Sri Ganganagar
How To Deal With Spinal Stenosis?

What is spinal stenosis: The narrowing of the gaps in the spine or the backbone is called as spinal stenosis. This leads to pressure on the nerves and the spinal cord. 5% of cases of spinal stenosis are seen in the low back of the lumbar spine. In some cases the narrowing of the spine leads to the compressing of the nerve root, which leads to pain in the leg.

Causes of spinal stenosis: It can be caused by aging, arthritis, trauma to the spine, spondylolisthesis and tumor of the spine

Symptoms of spinal stenosis: There is constant pain in the back and legs as stenosis pinches the nerve responsible for sensation and muscle power. Other symptoms are numbness and tingling in the legs, frequent falling and pain while walking.

Treatment of spinal stenosis:

  1. A routine program with exercises and physical therapy are the best treatment for spinal stenosis. The exercises are not a complete cure but they are beneficial in keeping the patient active. A physical therapy can be supervised and once the period of the same is over people easily transition to the exercise program. The key for exercise is starting slowly in order to build strength.
  2. Generally, the patients are counseled not to perform strenuous activities as that might worsen the symptoms of spinal stenosis. In case of lumbar stenosis, patients find it comfortable when they are flexed forward. The doctor might recommend walking while being bent over and leaning when using a walker if not walking upright; sitting in recliners is also recommended instead of straight back chairs.
  3. Injections of cortisone are usually given in the epidural space. This is believed to relieve the symptoms of spinal stenosis temporarily. Though there have been studies which question the use of these injections as they lead to the risk of osteoporosis related fractures. This is still being pondered over by the doctors as a suitable treatment option as it has its own benefits and risks.
  4. Medications such as the anti-inflammatory medicines like ibuprofen or aspirin are helpful in controlling the symptoms of spinal stenosis. Narcotic drugs might also prove to be helpful if used with care and for a short while. This is helpful for severe pain related to the nerves. Muscle relaxants like gabapentins might also be recommended. In some case antidepressants might also be given to provide relief from pain. 

Though side effects are a concern when using these medications and the patient should let the doctor knows about their allergies.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2598 people found this helpful
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