Spinal cord injury

Spinal cord injury is damage to the spinal cord that causes changes in its function, either temporary or permanent.

Spinal cord injuries can be divided into categories: complete transection, hemisection, central spinal cord lesions, posterior spinal cord lesions, and anterior spinal cord lesions.

Spinal cord injuries for devastating and typically result in lifelong neurologic deficits.

The spinal cord has limited functional repair abilities despite the presence of ependymal  stem cells lining the central canal throughout the cord.

10,000 injuries per year with motor vehicle crashes accounting or 37% of these injuries, crimes of violence for 26%, falls for 24% and sports injuries for 7%.

Incidence approximately 40-53 cases per million population.

More than 17,000 people in the US sustain a spinal cord injury each year.

Falls makeup a significantly percentage of spinal cord injuries in individuals age 65-84 years.

Male-female ratio of approximately 2.4:1.

Incidence and etiology vary by age.

Overall incidence has declined in younger age groups over time due to motor vehicle safety improvements,improved seatbelt laws, public education, drunk driving laws and enforcement.

Spinal cord injury incidence rates have increased over time in older age group because of the increased elderly population.

With acute injury with concomitant subluxation and dislocation should be reduced promptly.

Severe spinal cord injury leads to functional disconnection of the ascending and descending spinal pathways, impairing neural circuitry through and below the spinal cord injury.

The loss of oligodendrocytes after a spinal cord injury results in demyelination impairing propagation of action potentials in remaining or regenerated axons.

Myelinatedoligodendrocytes provide metabolic support for axons.

In clinically complete spinal cord injury, portion of neural tissue commonly remains intact across the injury site and may provide supraspinal influence on sublesional spinal circuitry.

Impaired respiratory performance is one of the most significant effects of spinal cord injury.

The more rostrally located a spinal traumatic lesion, the more pronounced the respiratory dysfunction and the more likely to result in respiratory failure.

High cervical cord lesions can destroy phrenic motor neurons and disrupt bulbospinal pathways.

Patients living with traumatic spinal cord injury have increased risk for developing health conditions directly linked to the impairment such as bowel and bladder problems and pressure sores, or occur as direct consequence of the impairment with decreased physical activity contributing to muscular skills deterioration or weakness.

Living with spinal cord injury leads to premature or accelerated secondary health conditions.

Poor psychological health is a result of Traumatic spinal cord injury with anxiety and depression common comorbid conditions implicated in poor self reported health, reduced function and increased risk for early mortality.

In spinal cord injury life satisfaction and adjustments are the strongest indicators of life expectancy.




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