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Complex spinal cord injuries

Lesionats medul·lars complexos a Vall d'Hebron

Acute spinal cord injuries, both in adults and children, are a complex and significant health problem that negatively affects the patient in terms of morbidity and mortality, but that also has an impact on their personal environment.

Description

Symptoms

The main symptoms are those derived from motor paralysis and lack of feeling below the area of the injury, and also and above all, effects on the autonomic nervous system which produce: changes to the cardiovascular and respiratory systems, to the urinary tract including changes to the capacity to store and evacuate urine, to the digestive system causing severe constipation, incontinence and faecal impaction, as well as changes to sexual function.

 

Diagnosis

  • Clinical examination according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)
  • Imaging tests: spinal MRI and vertebral CT scan.
  • Neurophysiological tests: electromyography and transcranial magnetic stimulation.
  • Urological tests: flowmetry and urodynamics

 

Typical treatment 

Treatment is integrated rehabilitation aimed at early intervention once the acute spinal cord injury has occurred in order to prevent complications and achieve the greatest functional independence possible in all physical, emotional and social aspects. Re-establish self-esteem by maximising the remaining abilities; encouraging the best social reintegration possible (active, independent and satisfying); and informing and advising the family to help them understand and manage the disability.

 

Prevention

When it comes to young people, prevention of complex spinal cord injuries is focused on avoiding risky activities: reckless driving or driving under the influence of alcohol and drugs, diving into shallow water and dangerous sports such as climbing, MTB or skiing. In the case of adults, especially the elderly, it centres on eliminating risks to prevent falling such as carpets or heights, by using walking sticks and controlling medication to avoid orthostatic hypertension which can cause falls.

Hospital o serveis complementaris relacionats

Traumatology, Rehabilitation and Burns Hospital

Where to find it
     
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