The spine is known as the “second lifeline” of human beings and is the “pillar and pillar” of human beings. It connects the internal organs and external limbs, so the spinal cord injury can be described as the “source of all diseases”. Epidemiological studies in recent years have shown that my country’s spinal cord injury has a bimodal distribution. The first peak is adolescents and young adults, and the second peak is the elderly over 65 years old. The most common injury was incomplete tetraplegia (31%), followed by complete paraplegia (25%), complete tetraplegia (20%), and incomplete paraplegia (19%). Spinal cord injury requires a lot of money to be treated, and the patients themselves are mostly young adults, so after the patients are injured, the family financial burden is very heavy. Therefore, we must start with prevention, strengthen early treatment, focus on functional rehabilitation, and reduce the mortality and disability rate of patients with spinal cord injury.
Pay attention to the handling method during first aid
Epidemiological investigations found that spinal cord injuries caused by falling from a height ranked first, accounting for 41.3%; traffic accidents followed, accounting for 22.3%; and heavy object injuries also accounted for a relatively high proportion, accounting for 18.6%. Spinal cord injury can cause lifelong disability, trauma rescue protection and proper transportation of patients are particularly important. According to the survey, about one-quarter of the patients were aggravated by improper rescue at the scene.
At the scene of traffic accidents or other accidents, if it is suspected that the injured person may injure the spine, the head must be fixed, especially the head must not be turned urgently; it is best to carry it in place, and the position of the injured person cannot be easily changed, and one person cannot lift the armpit. When carrying the lower limbs by one person, the wounded should be fixed on a hardwood stretcher; after the wounded is placed on a wooden board, use sand bags or folded clothing on both sides of the head and neck to prevent head rotation and keep the airway unobstructed.
People who encounter spinal cord injuries should strictly follow the above-mentioned methods, otherwise an incorrect action is very likely to cause more damage to the wounded and increase the difficulty of treatment. If you do not know how to first aid, it is recommended to dial 120 immediately and do not move the wounded casually.
“Five-step therapy” strives for a good prognosis
In clinical practice, it has been found that a single conservative treatment of spinal cord injury or surgical treatment is not satisfactory. Therefore, the “five-step therapy” can be used for treatment, which can strive for a better prognosis.
1. Drug treatment
Although trauma caused by primary spinal cord injury can not be reversed, but the drug treatment can prevent secondary damage and can promote axonal regeneration. The American Association for Acute Spinal Injury Research has confirmed that high-dose methylprednisolone is effective within 8 hours after spinal cord injury, which can improve microcirculation, reduce cellular calcium influx, inhibit lipid peroxidation, maintain neuronal excitation, and so on. However, the systemic high-dose methylprednisolone will bring some adverse effects, which requires clinicians to evaluate the pros and cons. In addition, some free radical scavengers, such as vitamin E, A, C, coenzyme Q10, calcium channel blockers, lidocaine, etc., have certain benefits in preventing secondary damage after spinal cord injury; disodium cytidine triphosphate and vitamins B1, B6, B12, etc. can promote the recovery of nerve function and are also used to treat spinal cord injuries.
2. surgical intervention
surgical indications, including unstable fracture, progressive neurological impairment, can not tolerate brace treatment. Surgical decision-making is individualized, and the main goals are: relieve spinal cord compression, preserve or improve function; establish a stable spine, prevent further functional damage and/or deformity; and provide patients with more meaningful functional recovery. It is generally believed in clinical practice that if the patient’s general conditions permit, surgery should be performed as soon as possible, and the race against time can maximize the recovery of nerve function.
3. Cell transplantation
there is joint action by the variety of cells, molecules and modulate spinal cord injury after self-repair process, but the limited extent of repair, not enough to restore spinal cord function, elsewhere at this time of cell transplantation need to promote nerve regeneration.
4. Treatment of complications
of spinal cord injury can cause many complications such as dyskinesia, lung disease or stool incontinence. After the patient has complications, the complications should be treated under the guidance of a doctor.
5. Rehabilitation training as soon as possible
Rehabilitation treatment is a very important part of the treatment of spinal cord injury, including urinary system and walking ability training, which can improve patients’ functional defects.