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Before the widespread use of spinal precautions in the 1970s, 55% of patients referred to spinal cord injury centers had complete spinal cord injury. [12] In the 1980s, spinal immobilization was initially used routinely for people who had experienced physical trauma, with little evidence to support its use. [ 21 ]
The rehabilitation process following a spinal cord injury typically begins in the acute care setting. Occupational therapy plays an important role in the management of SCI. [2] Recent studies emphasize the importance of early occupational therapy, started immediately after the client is stable.
An "incomplete" spinal cord injury involves preservation of motor or sensory function below the level of injury in the spinal cord. [19] To be classed as incomplete, there must be some preservation of sensation or motion in the areas innervated by S4 to S5, [ 20 ] including voluntary external anal sphincter contraction. [ 19 ]
Symptoms suggestive of cord compression are back pain, a dermatome of increased sensation, paralysis of limbs below the level of compression, decreased sensation below the level of compression, urinary and fecal incontinence and/or urinary retention. Lhermitte's sign (intermittent shooting electrical sensation) and hyperreflexia may be present.
Neurogenic shock results from damage to the spinal cord above the level of the 6th thoracic vertebra. [5] It is found in about half of people who have a spinal cord injury within the first 24 hours, and usually persists for one to three weeks. [5] Neurogenic shock may be caused by severe brain injury. [6]
Commonly intra-scapular pain is referred from the lower cervical spine. Contributing factors to injury include; lack of strength, poor posture, overuse injuries (such as repetitive motion), or a trauma (such as a car accident or sports injury). Often thoracic pain can be aggravated twisting, side bending and with prolonged bent spinal postures.
A more detailed and rapid neurological evaluation is performed at the end of the primary survey. This establishes the patient's level of consciousness, pupil size and reaction, lateralizing signs, and spinal cord injury level. The Glasgow Coma Scale is a quick method to determine the level of consciousness, and is predictive of patient outcome ...
A burst fracture is a type of traumatic spinal injury in which a vertebra breaks from a high-energy axial load (e.g., traffic collisions or falls from a great height or high speed, and some kinds of seizures), with shards of vertebra penetrating surrounding tissues and sometimes the spinal canal. [1]