What is it about ?
Our nervous system is made up of a central part (the brain and spinal cord) and a peripheral part (the nerves). The spinal cord is the part of the central nervous system located in the spine. It starts in the neck, under the skull, where it connects to the brain, and goes down to the lower back. It is surrounded by 3 membranes between which the cerebrospinal fluid floats. Starting from the spinal cord, the nerve roots branch out at the level of each vertebra.
Motor nerves go to muscles and organs. They ensure their proper functioning. Sensory nerves receive stimuli from the body and the skin. This is what allows us to perceive pain, hot and cold, and also to have the sense of touch. They allow the brain to send and receive information from every point in the body.
There are a whole host of conditions that can damage the spinal cord. The most frequent are trauma, often caused by accidents, and infections of viral or bacterial origin. Systemic diseases such as LED and the sarcoidosis can cause inflammation of the spinal cord. Diseases like Sep and the SLA also affect the spinal cord.
How to recognize them?
It may be that vertebral fractures sever the spinal cord. This is called a spinal cord injury. In this case, all the muscles are paralyzed below the level of the lesion and the tenderness disappears in this area. For example, in the case of a spinal cord injury in the lumbar region, both legs will be paralyzed and unresponsive (paraparesis). With this type of injury at the back of the neck, both arms and legs are paralyzed and unresponsive (tetraparesis).
As the muscles no longer work, they will gradually become thinner and, so to speak, melt (muscle atrophy). At the same time, a number of functions will also deteriorate, such as bladder or bowel control, leading to incontinence. The nerves in the muscles themselves can remain intact and provide stimuli, which are therefore not controlled by the brain. In doing so, abnormal muscle activity may develop. Involuntary muscle contractions are called spasms. Over time, these spasms can deform the limbs which will end up in an abnormal position (spasticity).
With bleeding and a heart attack, symptoms develop within a few hours and include neck pain, back pain, muscle failure and altered sensitivity.
With infections of the spinal cord, there are often only general symptoms at first, such as fever, headache and poor appetite. Without treatment, signs of damage to the spinal cord, such as muscle weakness and paralysis and a decrease or disappearance of the sensitivity, develop gradually.
For diseases of the spinal cord such as Sep, the evolution is much slower and can sometimes even take several years. You often notice small changes that you don’t pay much attention to. For example, involuntary urine loss and visual disturbances.
What can you do ?
In the event of spinal cord injury, it is very important to avoid spasticity. The family and the physiotherapist must cooperate closely in this regard. Prevent deformities with suitable exercises and even moving limbs that are completely paralyzed. Avoid bedsores by using special and adapted material (pillows, mattresses, etc.). Change your posture, avoiding continuous pressure in the same places, such as the tailbone, shoulders and / or heels. When the patient can no longer urinate spontaneously, the bladder should be emptied by catheterization.
What can your doctor do?
Treatment depends on the cause. High doses of antibiotics will be given for infections. Cortisone and drugs acting on natural resistance can inhibit (= slow down) systemic diseases. Anticoagulants will be prescribed in the event of a heart attack. Surgery is rarely used.
Rehabilitation will only take place in the hospital or in a specialized service during the first phase. The basic treatment will always be done at home.
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