Treatments for Spinal cord injury
Treatments for Spinal cord injury
The list of treatments mentioned in various sources
for Spinal cord injury
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Emergency treatments
- Corticosteroids
- Methylprednisolone
- Stabilization of the vertebrae
- Rehabilitation
- Aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities
- Methylprednisolone appears to reduce the damage to nerve cells if it is given within the first 8 hours after injury
- Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support
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Hospital statistics for Spinal cord injury:
These medical statistics relate to hospitals, hospitalization and Spinal cord injury:
- 0.005% (612) of hospital consultant episodes were for injury of nerves and spinal cord at neck level in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 84% of hospital consultant episodes for injury of nerves and spinal cord at neck level required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 75% of hospital consultant episodes for injury of nerves and spinal cord at neck level were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 25% of hospital consultant episodes for injury of nerves and spinal cord at neck level were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Medical news summaries about treatments for Spinal cord injury:
The following medical news items
are relevant to treatment of Spinal cord injury:
Discussion of treatments for Spinal cord injury:
While recent advances in emergency care and
rehabilitation allow many SCI patients to survive, methods for reducing
the extent of injury and for restoring function are still limited.
Immediate treatment for acute SCI includes techniques to relieve cord
compression, prompt (within 8 hours of the injury) drug therapy with
corticosteroids such as methylprednisolone to minimize cell damage, and
stabilization of the vertebrae of the spine to prevent further injury.
(Source: excerpt from
NINDS Spinal Cord Injury Information Page: NINDS)
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Book Excerpts: Treatment of Spinal cord injury
Treatments of Spinal cord injury: Online Medical Books
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Low Back Pain/Swelling:
Treatment
(In a Page: Signs and Symptoms)
-
In absence of red flag symptoms, return to activity as soon as possible; rest has not been shown to improve recovery
-
Acetaminophen, NSAIDs, opioids, and/or muscle relaxants for pain; epidural corticosteroid injections may be indicated for resistant pain
-
Patient education (weight loss, exercise, proper back biomechanics and ergonomics)
-
Physical therapy, including pain relief modalities (ice, heat, ultrasound), stretching, strengthening, aerobic conditioning, and relaxation therapy
-
Surgery may be indicated for refractory disease, large neurologic deficits, unbearable pain, or significant limitations
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» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Back Pain:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Muscular strain: Muscle relaxants, NSAIDs, rest, and reduction of exacerbating activities
-
-
-
Disk herniation: Physical therapy, surgery is rarely indicated in children and adolescents
-
Spondyloarthropathy: NSAIDs, exercise
-
Scoliosis: Conservative management with observation, NSAIDs, bracing or surgery if more severe
-
Gynocologic etiologies
–Menstrual cramps: NSAIDs, OCPs for severe cases
–PID: Appropriate cultures, treatment with antibiotics
–Endometriosis: hormonal therapy such as OCPs may
be effective, surgical ablation is rarely required
-
UTI: Antibiotics
-
Urolithiasis: Pain management followed by high fluid intake
-
Infection: Diskitis requires 4–6 weeks of IV antibiotics
-
-
-
Tumors: Referral to oncologist
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Analgesia:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Suspect spinal cord injury if the patient complains of unilateral or bilateral analgesia over a large body area, accompanied by paralysis. Immobilize his spine in proper alignment, using a cervical collar and a long backboard, if possible. If a collar or backboard isn’t available, position the patient in a supine position on a flat surface and place sandbags around his head, neck, and torso. Use correct technique and extreme caution when moving him to prevent exacerbating spinal injury. Continuously monitor respiratory rate and rhythm, and observe him for accessory muscle use because a complete lesion above the T6 level may cause diaphragmatic and intercostal muscle paralysis. Have an artificial airway and a handheld resuscitation bag on hand, and be prepared to initiate emergency resuscitation measures in case of respiratory failure.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Back pain:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient reports acute, severe back pain, quickly take his vital signs, and then perform a rapid evaluation to rule out life-threatening causes. Ask him when the pain began. Can he relate it to any causes? For example, did the pain occur after eating? After falling on the ice? Have the patient describe the pain. Is it burning, stabbing, throbbing, or aching? Is it constant or intermittent? Does it radiate to the buttocks or legs? Does he have leg weakness? Does the pain seem to originate in the abdomen and radiate to the back? Has he had a pain like this before? What makes it better or worse? Is it affected by activity or rest? Is it worse in the morning or evening? Does it wake him up? Typically, visceral-referred back pain is unaffected by activity and rest. In contrast, spondylogenic-referred back pain worsens with activity and improves with rest. Pain of neoplastic origin is usually relieved by walking and worsens at night.
If the patient describes deep lumbar pain unaffected by activity, palpate for a pulsating epigastric mass. If this sign is present, suspect a dissecting abdominal aortic aneurysm. Withhold food and fluid in anticipation of emergency surgery. Prepare for I.V. fluid replacement and oxygen administration. Monitor the patient's vital signs and peripheral pulses closely.
If the patient describes severe epigastric pain that radiates through the abdomen to the back, assess him for absent bowel sounds and for abdominal rigidity and tenderness. If these occur, suspect a perforated ulcer or acute pancreatitis. Start an I.V. for fluids and drugs, administer oxygen, and insert a nasogastric tube while withholding food.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Spinal injuries:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The primary treatment after a spinal injury is immediate immobilization to stabilize the spine and prevent cord damage; other measures are supportive. Cervical injuries require immobilization, using a type of cervical immobilization device (CID) on both sides of the patient’s head, a hard cervical collar, or skeletal traction with skull tongs or a halo device.
Treatment of stable lumbar and dorsal fractures consists of bed rest on firm support (such as a bed board), analgesics, and muscle relaxants until the fracture stabilizes (usually in 10 to 12 weeks). Later measures include exercises to strengthen the back muscles and use of a back brace or other device to provide support while walking.
An unstable dorsal or lumbar fracture requires a plaster cast, a turning frame and, in severe fracture, a laminectomy and spinal fusion.
When the spinal injury results in compression of the spinal column, neurosurgery may relieve the pressure. If the cause of compression is a metastatic lesion, chemotherapy and radiation may relieve it. Surface wounds accompanying the spinal injury require tetanus prophylaxis unless the patient has been immunized recently.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Abdominal trauma:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
I.V. fluid replacement, surgical repair, analgesics, antibiotics
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Analgesia:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Suspect spinal cord injury if the patient complains of unilateral or bilateral analgesia over a large body area, accompanied by paralysis. Immobilize his spine in proper alignment, using a cervical collar and a long backboard, if possible. If a collar or backboard isn’t available, place the patient in a supine position on a flat surface and place sandbags around his head, neck, and torso. Use correct technique and extreme caution when moving him to prevent exacerbating the spinal injury. Continuously monitor respiratory rate and rhythm, and observe him for accessory muscle use because a complete lesion above the T6 level may cause diaphragmatic and intercostal muscle paralysis. Have an artificial airway and a handheld resuscitation bag on hand, and be prepared to initiate emergency resuscitation measures in case of respiratory failure.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Back pain:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient reports acute, severe back pain, quickly take his vital signs; then perform a rapid evaluation to rule out life-threatening causes. Ask him when the pain began. Can he relate it to any causes? For example, did the pain occur after eating? After falling on the ice? Have the patient describe the pain. Is it burning, stabbing, throbbing, or aching? Is it constant or intermittent? Does it radiate to the buttocks or legs? Does he have leg weakness? Does the pain seem to originate in the abdomen and radiate to the back? Has he had a pain like this before? What makes it better or worse? Is it affected by activity or rest? Is it worse in the morning or evening? Does it wake him up? Typically, visceral-referred back pain is unaffected by activity and rest. In contrast, spondylogenic-referred back pain worsens with activity and improves with rest. Pain of neoplastic origin is usually relieved by walking and worsens at night.
If the patient describes deep lumbar pain unaffected by activity, palpate for a pulsating epigastric mass. If this sign is present, suspect dissecting abdominal aortic aneurysm. Withhold food and fluid in anticipation of emergency surgery. Prepare for I.V. fluid replacement and oxygen administration.
If the patient describes severe epigastric pain that radiates through the abdomen to the back, assess him for absent bowel sounds and for abdominal rigidity and tenderness. If these occur, suspect a perforated ulcer or acute pancreatitis. Start an I.V. line for fluids and drugs, administer oxygen, and insert a nasogastric tube while withholding food.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Spinal cord defects:
Treatment
(Handbook of Diseases)
Spina bifida occulta usually requires no treatment. Treatment of meningocele consists of surgical closure of the protruding sac and continual assessment of growth and development.
Treatment of myelomeningocele requires repair of the sac and supportive measures to promote independence and prevent further complications. Surgery doesn’t reverse neurologic deficits. A shunt may be needed to relieve associated hydrocephalus.
If the patient has a severe spinal defect, short- and long-term treatment will require a team approach, including a neurosurgeon, orthopedist, urologist, nurse, social worker, occupational and physical therapists, and parents.
Rehabilitation
In children or adults, rehabilitation measures may include:
❑ waist supports, long leg braces, walkers, crutches, and other ortho-pedic appliances
❑ diet and bowel training to manage fecal incontinence
❑ neurogenic bladder management to reduce urinary stasis, possibly intermittent catheterization, and antispasmodics, such as bethanechol or propantheline. In severe cases, insertion of an artificial urinary sphincter is often sucsuccessful; a urinary diversion is used as a last resort to preserve kidney function.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Spinal injuries:
Treatment
(Handbook of Diseases)
The primary treatment after spinal injury is immediate immobilization to stabilize the spine and prevent cord damage; other treatment is supportive. Cervical injuries require immobilization, using sandbags on both sides of the patient’s head, a hard cervical collar, or skeletal traction with skull tongs or a halo device. When patients show clinical evidence of cord injury, high doses of methylprednisone are started.
Supportive treatment
Treatment of stable lumbar and dorsal fractures consists of bed rest on firm support (such as a bed board), analgesics, and muscle relaxants until the fracture stabilizes (usually 10 to 12 weeks). Later treatment includes exercises to strengthen the back muscles and a back brace or corset to provide support while walking.
An unstable dorsal or lumbar fracture requires a plaster cast, a turning frame and, in severe fracture, laminectomy and spinal fusion.
Other treatment
When the damage results in compression of the spinal column, neurosurgery may relieve the pressure. If the cause of compression is a metastatic lesion, chemotherapy and radiation may relieve it. Surface wounds accompanying the spinal injury require tetanus prophylaxis unless the patient has had recent immunization.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Analgesia:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Maintain spinal alignment during transport for laboratory or radiologic procedures. Monitor the patient’s vital signs and neurologic assessment closely. Provide continuous emotional support to the patient and his family.
Prevent pressure ulcer formation by such measures as meticulous skin care, massage, and frequent repositioning, especially when significant motor deficits hamper the patient’s movement. Guard against scalding by testing the water temperature before the patient bathes.
Patient teaching
Explain all tests and procedures. Advise the patient to test the water at home using a thermometer or a body part with intact sensation before showering or bathing.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Back pain:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor the patient closely if the type and location of back pain suggest a life-threatening cause. Stay alert for increasing pain, altered neurovascular status in the legs, loss of bowel or bladder control, altered vital signs, sweating, and cyanosis.
Until a tentative diagnosis is made, withhold analgesics to avoid masking symptoms. Withhold food and fluids until it’s determined whether the patient requires surgery. Once a medical emergency is ruled out, make him as comfortable as possible by elevating the head of the bed, placing a pillow under his knees, and administering pain medications. Prepare the patient for a rectal or pelvic examination, routine blood tests, urinalysis, computed tomography scan, biopsies, and X-rays of the chest, abdomen, and spine.
Fit the patient for a corset or lumbosacral support. Refer him to a physical therapist, occupational therapist, massage therapist, or psychologist, as indicated.
Patient teaching
Explain all tests and procedures. Instruct the patient not to wear a lumbosacral support in bed. Describe such pain-relief measures as cold therapy, warm baths, mattress choices, and backboards. Instruct the patient and his family about relaxation techniques, such as deep breathing, biofeedback, and transcutaneous electrical nerve stimulation.
If the patient has chronic back pain, reinforce instructions about bed rest, analgesics, anti-inflammatory medications, and exercise. (See Exercises for chronic low back pain, page 41.) Help him recognize the need to make lifestyle changes, such as losing weight or correcting poor posture. Advise the patient with acute back pain secondary to a musculoskeletal problem to continue his daily activities as tolerated rather than staying on total bed rest.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Back pain:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient has chronic back pain, reinforce instructions about bed rest, analgesics, anti-inflammatories, and exercise. Also, suggest that he take daily warm baths to help relieve pain. Help the patient recognize the need to make necessary lifestyle changes, such as losing weight or correcting poor posture. Advise patients with acute back pain secondary to a musculoskeletal problem to continue their daily activities as tolerated, rather than staying on total bed rest.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Analgesia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for spinal X-rays and imaging studies, and maintain spinal alignment and stability during the tests.
▪ Focus your care on preventing further injury to the patient because analgesia can mask injury or developing complications.
▪ Prevent formation of pressure ulcers through meticulous skin care and frequent repositioning, especially when significant motor deficits impair the patient's mobility.
▪ Guard against scalding by testing the patient's bath water temperature before he bathes.
Patient teaching
▪ Advise the patient to test bath water temperature at home using a thermometer or a body part with intact sensation.
▪ Explain all tests and procedures.
▪ Teach the patient about the diagnosis, once established, and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Back pain:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient closely if the back pain suggests a life-threatening cause.
▪ Be alert for increasing pain, altered neurovascular status in the legs, loss of bowel or bladder control, altered vital signs, sweating, and cyanosis.
▪ Withhold food and fluids in case surgery is necessary.
▪ Administer analgesics, as ordered, and evaluate their effect.
▪ Make the patient as comfortable as possible by elevating the head of the bed and placing a pillow under his knees.
▪ Encourage relaxation techniques such as deep breathing.
▪ Anticipate diagnostic testing, such as routine blood tests, urinalysis, a computed tomography scan, magnetic resonance imaging, appropriate biopsies, and X-rays of the chest, abdomen, and spine.
▪ Fit the patient for a corset or lumbosacral support.
▪ Provide heat or cold therapy, a backboard, a convoluted foam mattress, or pelvic traction, as ordered.
▪ Refer the patient to other professionals, such as a physical therapist, an occupational therapist, or a psychologist, if indicated.
Patient teaching
▪ Explain pain-relief measures to the patient.
▪ Teach him about alternatives to analgesic drug therapy, such as biofeedback and transcutaneous electrical nerve stimulation.
▪ Provide information about use of anti-inflammatory drugs and analgesics.
▪ Discuss lifestyle changes, such as weight loss or correcting posture.
▪ Teach relaxation techniques such as deep breathing.
▪ Instruct the patient on correct use of corset or lumbosacral support.
▪ Explain diagnostic tests and procedures.
▪ Teach the patient about the cause of his back pain and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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