PARAPLEGIA

PARAPLEGIA

What is spinal cord?

The spinal cord continuing in the form of an extension of our brain from the channel formed in the middle by the union of the spinal bones is the name of the nerve structure that connects the brain to muscles, skin and internal organs. Thanks to this neural connection that your spinal cord provides, we can feel the senses of touch and pain in our skin and move our arms and legs voluntarily. Vertebra has a duty also to fulfill the normal functions of the internal organs.

What is paraplegia?

Paraplegia is a paralytic condition that caused by a disease developing in the spinal cord or vertebrae around it which may compress the spinal cord and cause damage. As a result it causes loss of power in the limbs and / or the legs, deterioration of the senses and functions of some internal organs.

Paraplegia usually occurs as a result of traffic accidents, falling from the top, firearm injuries, penetrating stab wounds, dive headfirst to shallow water, sports injuries. Other causes of paraplegia include inflammatory conditions of the spinal cord, tumors, calcification of vertebrae, shift of the spinal bones, and near-spinal operations.

What are symptoms of paraplegia?

If there is spinal cord injury at the neck level, paralysis develops in both arms and legs; if there is an injury at the level of the back and waist paralysis develops only in the legs. Depending on the severity of the injury in the paraplegia, dysfunctions may also occur in voiding, defecation, and reproduction. Other than these, depending on the level and severity of the injury, blood pressure can be reduced, sudden blood pressure changes, impaired sexual function, excessive sweating, redness on the face, excessive contraction in the arms and legs can also be seen.

Levels of paraplegia

Tetraplegia: 

As a result of injury to the neck level of the spine, the paralysis develops both in the arms and in the legs. This is called tetraplegia. In this level of paraplegia, respiratory muscles are also affected leading to break down in functions such as regular breathing and coughing. Voiding, defecation and reproductive functions are negatively affected by this level of paralysis.

Paraplegia:

As a result of the injury of the spine at the back level, the paralysis develops only in the legs. This is called paraplegia. In this level of paraplegia the arms are not affected but may develop voiding, defecation and sexual dysfunctions.

Treatment of paraplegia

First aid intervention for people exposed to injuries that can cause paraplegia is very important. It may cause spinal cord injuries with interventions to be performed by inexperienced persons in the accident area. In order to minimize the likelihood of paraplegia, first aid and transfer to a hospital in such an accident should be done by an experienced first-aid team.

Today, unfortunately, there is no cure of a cut in spinal cord. Approximately 80% of patients with spinal cord injuries continue to their lives in wheelchairs.

Patients with paraplegia should be evaluated by a physiotherapy and rehabilitation specialist in terms of planning the rehabilitation period following first aid and surgical treatment. In terms of a fine rehabilitation, there is a need for a rehabilitation team that includes physiotherapy and rehabilitation specialist, physiotherapist, nurse, occupational therapist, psychologist, social worker and orthopedic specialist. If necessary, opinions from other branch specialists should be taken. In the rehabilitation process, in general, necessary activities should be done to resume sitting balance, to transfer independently from the chair or seat to the bed, to be freely mobilized with a wheelchair, to eat, and to meet daily personal needs, while varying according to the severity of the spinal cord injury. If there is sufficient muscle strength in the paralyzed patient, walking exercises can be started with or without devices. After at least 6 months of active rehabilitation process, patients with paraplegia must be reintegrated to the social life.

Bladder rehabilitation should also be performed if there are problems with voiding in the paraplegia. Diagnostic methods using urinal ultrasonography and urodynamic tests are used in the detection of voiding problems in paraplegia. Fluid restriction, clean intermittent catheterization and various medications can be used when needed for patients with paraplegia who have problem of voiding. Urinary tract infections and renal failure can develop in paraplegia patients without proper bladder rehabilitation. Robotic rehabilitation in the treatment of paraplegia has also been successfully implemented in recent years.

Scientific studies on experimental animals in the treatment of paraplegia by stem cells are promising. Further work to be done in this regard is likely to be a new hope in the treatment of paraplegia.