How does spinal injury occur?
The most common cause of spinal fractures and dislocations is road traffic accidents followed by fall from height (usually a fall from a tree). Most commonly spine fractures occur in the middle of the spine followed by the neck. Normally, the spinal bones are very strong and therefore, a lot of force is needed to break them. But, patients with ankylosing spondylitis and osteoporosis are also predisposed to developing spinal fractures even with trivial trauma like a fall at home or a slip in the bathroom.
What is a spinal cord injury?
Most spine fractures do not injure the spinal cord. Such fractures have an excellent outcome. Most of them can be managed without surgery and sometimes spinal fixation surgery with implants may be needed. Sometimes, spinal fractures can damage the spinal cord, resulting in paralysis. This paralysis can be permanent, and have devastating consequences on the patient and his family. If paralysis is incomplete, there is a reasonable chance of improvement in paralysis, but if paralysis in complete, then recovery is very rare. Surgery is almost always needed in cases where the spinal cord is injured.
When is CT or MRI needed for a spinal injury patient?
We evaluate all our patients with Spinal fractures with an X-ray and CT (CT is better than MRI to see the fracture and bony details) and order an MRI if there is paralysis or we feel it will add new information.
Can spinal fractures be treated without surgery? What braces can be used in spinal injury?
Patients with spinal fracture but no paralysis may be given a collar or a trunk brace if required. For neck injuries, we sometimes use a Halo Vest (Halo is a metallic ring around the skull which is connected to a thermoplastic vest with metallic uprights to give external support to the neck spinal bones).
Is bed rest needed for spinal injury patients?
It is a myth that spine fracture patients need to be on bed rest for a few months. We do not use bed rest to treat spinal fractures. Rather, we make these patients walk as soon as possible (as tolerated within the limits of pain) with or without a brace.
What are the surgical options for fixing a spine fracture?
Some of these patients may need a Spine Surgery to fix these fractures. This may be done using plates or rods and screws made of Titanium. Some of these fractures can be fixed using Minimally Invasive Spine Surgery (MISS). Patients with paralysis almost always require a Spine Surgery to decompress the spinal cord and to fix their neck or back.
What are the chances of recovery of paralysis?
If the paralysis is incomplete to start with, one can hope for the paralysis to improve over a period of 3 months to 1 year.
If the paralysis is complete at the time of injury it may never recover. The aim of surgery in patients with complete paralysis, is to facilitate their nursing care; prevent bed sores and pneumonia; and mobilize them at the earliest on a wheelchair. Unfortunately, ongoing research from all over the world is yet to find an effective treatment by which patients with complete paralysis can be made to walk again.
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