Effects of spinal injuries

1995/01/01 Furundarena Salsamendi, Jose Ramon Iturria: Elhuyar aldizkaria

• Osasuna

Through the advertising campaigns for the prevention of traffic accidents, I will try to show the consequences of the injuries of the known spine, based on a work recently published by the Ditunno and Formal doctors of Philadelphia.

The United States currently has 200,000 patients affected by spinal cord injuries, and this number is expected to increase due to the 10,000 new cases that appear each year and the increasing survival of these patients. The main causes of spinal cord injuries are vehicle accidents (45%), falls (22%), violent acts (16%) and sports accidents (13%). 82% of those affected by spinal cord injuries are men and have an average age of 31 years at the time of the accident.

Medical Problems Medical problems

The first thing to know is that the typical symptoms and signs that appear due to certain diseases vary (calculations or kidney stones can appear without colic, without tension in the abdominal wall, deep vein thrombosis of the lower extremities without hardening the apples of gamba, etc. ). ).

Neurological problems

These patients need to perform a periodic neurological study, taking into account that their neurological condition can improve after the hospital's exit. Many patients gain the functional capacity of some muscles during the first 6 months and others from 6 months to 2 years. We do not know how this muscle composition is achieved, but some of the causes would be the disappearance of the injured part edema and the appearance of peripheral outbreaks of the nerves.

Urinary tract infections Urinary tract infections

In this type of patients, urinary tract infection has been defined as: invasion of bacterial tissues and reaction of the resulting tissues with signs and/or symptoms. Bacteriuria without symptoms or signs should not be treated and its meaning is not clear.

These infections have a second degree of complication with 20% annually. They are the largest producers of fever and chills and can cause sepsis or widespread infection and death.

These infections are due to the impossibility of emptying the bladder normally. If the spinal cord injury is total, the urinary system is left without contraction of the brain controlled bladder and relaxation of the sphincter. In some patients, the bladder maintains a reflex that causes contraction of the bladder and expulsion of the urine, but acting against the unrelaxed sphincter, causing high pressures in the upper urine pathways with risk of infection and other damage. In other patients, the flaky bladder appears, which is expelled when the urine is overflowing, but always with a significant amount of waste deposited in the bladder and at risk of infection.

To maintain the proper functioning of the bladder, periodic catheterization may be necessary, that is, the placement of probes to expel all urine and normalize the pressure of the bladder. In the worst case, the definitive catheterization will be used, in which it will take into account the ingestion of many fluids for the abundant expulsion of urine and the obstruction of the probe, the inflation of the bladder and avoid the traumas caused by the catheter.

Annually, bladder changes, vesicoureteral reflux and cystogram of urinary stones detection and some technique of renal recognition will be made.

Pressure ulcers

They are causing many problems with an annual impact of 23%. They appear as a result of pressure exerted by a body area for a long time and the best prevention is the frequent alteration of the patient's postures.

Although the wound we can see on the skin is small, there can be a deep ulcer inside, which should be carefully studied. Many times it is necessary to remove the edges well and cover the wound, forbidding the weight of the body. Large ulcers, even with the best treatment, are only cured at a speed of one millimeter per day.

Exaggeration

It is a tonic reflection of muscle contraction that can be due to small stimuli in a variable way. It appears after the hospital's departure and affects 75% of patients per year. In some cases, treatment is required and is controlled through periodic muscle extensions and certain medications.

Depression Depression Depression Depression

Most patients with spinal cord injuries lack depression, despite having a higher propensity for suicide than in other people. In cases of depression, it is due to isolation and unemployment.

Social problems Social problems

95% of these patients can go to their home or to a residence. Approximately half gets back to work. Couple problems are more common: separations and problems between spouses. Although they have less desire to live compared to other people, most of those who have been injured for years say they have good quality of life.

Sexual function Sexual function

They do not lose sexual desire. Most men have reflex erections and if the injury is from low areas of the spine, they can also get psychogenic erections. The sexual potency can be increased by applying prosthesis to the penis. Less analysis of female sexuality.

Most maintain an active sexuality. If the lesion is total, most men are sterile, although sometimes a seed can be obtained by electrostimulation. In women at first, the rule is lost, but then it reappears and may become pregnant.

Influence of age

The hope of survival of these patients is less than that of other people, but it is increasingly longer. As progress is made in the prevention and treatment of urinary infections, pressure ulcers and respiratory infections, the results will improve.

Therefore, spinal cord injuries can cause complications, and in some cases they can be difficult to swim. They will be very careful patients and will need the help of the family and the sanitary. Associations formed by those affected by these injuries are very useful to achieve a good quality of life.