Spinal cord trauma (TRM) or trauma of the méspinal cord is a lesionón acute that affects nervous tissue and may involve the spine. The intensity of the dayñor it can vary from very light to the whole section.ón medullary. It is presented by several factors, either direct or indirect.
The direct ones are infrequent and are due to the applicationón the energyíon the point where the lesion occursón.
Indirect factors are caused by caílow altitude damage or a bullet impact. In this case it can be total and partial.
Total is when it appears in the vécervical vertebrae causing a disconnectionón between the brain and the body. Hereí they lose sensation, mobility and the senses.
Partial is when they are generated in the dorsal vertebrae affecting from the place of impact to the lower extremities.
If the column shows a deviationón abnormal, be correctedá through surgeryía.
When there is an excess of the volume of líliquid that covers the méspinal game, be extractedá using a laminanectomía.
Index
Diagnóstico of rachimedullary trauma
The diagnosis must be exclusively clinical.ínico. The polytraumatized patient subjected toétaking it to an evaluationón radiológica. The cervical spine should be taken (lateral), tórax and pelvis.
If there is no evidence of injuryón óeither through RX, Scannerícomputed tomography or magnetic resonance imagingética, then it will be determinedá by neurological examinationógico. will be requiredá of continuous evaluations at hourly intervals to analyze the situationón neurológica: reflexes, muscular strength, sensitivity changes, control of the stressesínteres, etc.
Spinal cord trauma should be suspected in a case of:
- car accidentíStico or Violent Impact.
- torqueón lateral.
- Breatheón abnormal.
- Péloss of control of the spheresínteres.
- Caíthe.
- If isán compromised sensation and motor ability below the lesionón.
- Hypotensionóarterial n and decrease in heart rateíaca.
Causes of spinal cord trauma
road accidentsáfico
In traffic accidentsáfico is very común spinal cord injuries, back and neck. When a car hits, actúsudden changes in speed exerting forces on the occupants of the same, producing a whiplash. This type of injury can be reflected rádirectly in the spinal cord.
Caíthe
slips and caídays can vary from a moretón even a back fracture that can bring severe painóunique and in some cases requireá the circleía.
Sports injuries
Spaghettién are a frequent cause of spinal cord trauma.
A tumor in the méspinal game
These tumors can be of intramedullary origin, extramedulares y extradural (between the meninx and the bones of the spine).
Consequences of spinal cord trauma on other systems
Cardiovascular system. Initially, hypertensiveón arterial which will later becomeá and hypotensionón and brachycardia.
Respiratory system. It's likeún the patient suffers from respiratory failure. Si la lesión occurs in the upper part of the cervical medulla, compromise the vévertebrae from C3 to C6 and affectá in one breathón asyncrónica.
Genitourinary system. Commitment of óorgans the urinary tract, with a high probability of infectionón. Spinal cord injuries are very common in traffic accidents., let's goñones are not able to filter toxins with possible hydronephrosis. Presence of údec ulcersúsmall.
Trauma raquimedular
an immobilizationón immediate and proper beá the first and más important step, Spinal cord injuries are very common in traffic accidents.. Spinal cord injuries are very common in traffic accidents., así the patient will haveá higher chances of ésuccess in your recoveryón.
The patient must have good ventilation.ón and oxygenationón.
The médico must review the injury very wellón, if there is swellingóno redness. This in order to prevent deep thrombosis.
Applicationón early physiotherapy to prevent joint stiffness or deformity and to help reduce considerably mútense centuries.
In case of tumor in the médrama, be extractedá through surgeryía. In his recoveryón loss of sensitivity is normal, there are very few cases in which the patient never recovers that sensitivity.
Corticosteroid-type steroid hormone medications are recommended, in order to deflate the méspinal game.
In conclusionón treatment dependá the level and intensity of the lesionón, well be itúrgic o méI say.
surgical proceduresúrgic in case of MRT
Cervical spine. Si la lesión is mild and occurs between the first two vécervical vertebrae can be treated with méall orthopésay how órtesis cervical. In case of severe injuries, proceedá to surgical treatmentúrgic, where to placeá wiring or plate and screws.
thor columnácat. When the trauma is at the level of the tórax, surgery should be appliedíto as soon as possible in which the bones should be realigned, extract fragments óbone or fuse broken vertebrae.
Región lumbar. the surgeryía in this area should be done with the patient asleep under the effect of general anesthesia. The purpose of the surgeryía is to remove the bone that is causing pressureón on the nerve, in case the trauma causes a compressionón of the spine at the lumbar level.
Stadiumísticas
The statsístatistics indicate that the populationón más affected with this type of trauma ranges from the 15 until the 30 añand adults older than 65 años.
If spinal cord trauma is not detected in time, he isñor it can be irreversible and of lesión permanent.
