It’s all in the spine

Importance of our spine needs to be highlighted; awareness must be spread regarding the impact of a spine injury on our body and how we can protect it and keep it safe

BENGALURU: The spinal cord is one of the most essential components of our central nervous system. Marking Spinal Cord Injury Day on September 5, we should be aware of the impact of a spine injury on our body and the ways we can protect our spine and keep it safe.

In order to realise how our body can get affected by a spinal cord injury, it is important to know how the spine works. Several nerves originate from the brain and reach the skin, muscles and body organs through the spinal cord. A person with a spinal cord injury can develop several ‘secondary’ complications and issues which need to be addressed from time to time.

Skeletal system: This is one of the body systems that get primarily hit due to a spine injury. Following an injury, some calcium and minerals leave the bones which may gradually get accumulated in the urinary system causing stones. This is why it is advised to remain as much active as possible post a spine injury. Difficulty in movement may result in joint stiffening of knees, elbows, shoulders and may cause pain. Range of Motion (ROM) exercise is of great help by enabling complete movement of joints by correct positioning in bed.

Urinary system: Many times, a person with spinal cord injury will not be able to empty his bowel and bladder. In such situations, either a person has to be on a full-time urinary catheter or has to do intermittent self-catheterisation. In either of these situations, there is a substantially increased risk of urinary tract infections that need to be treated with antibiotics. Preventing such infections by following hygienic and sterile catheterisation techniques is always helpful.

Bowels: Similar to urinary issues, many patients with spinal cord injury also have a difficulty in emptying their bowels resulting in constipation. The abdominal muscles may have to be put on use to push the stool out depending on the extent and level of spine injury. A spinal cord injury can thereby result in bowel accidents, constipation and impaction. Following a spinal cord injury, it is essential to re-train the bowels.  
Skin: The spinal cord sends messages to the skin to protect it from being hurt. Once the spine is injured or damaged, the transmission of these signals may pause and the skin may become numb to certain feelings of discomfort. Also, these patients usually have limited mobility and are confined to bed/wheel-chair most of the time, increasing pressure on certain points on the skin. Daily skincare, regular skin check-ups and avoidance of pressure points by frequent change in positioning can help in these situations.

Respiratory system: Respiratory system may also get affected by a spinal cord injury. The very ability to move air in and out of the lungs depends on muscles which are controlled by the nerves in the spine. Regular chest physiotherapy and breathing exercises along with early recognition and prompt treatment of respiratory problems can prevent major complications like pneumonia or respiratory failure.
Autonomic function: Spinal cord injury may affect autonomic functions as well. The autonomic nervous system that runs in and out of the spinal cord manages the glands, digestion, heart, temperature, blood pressure and more. A spinal cord injury may result in most of these functions getting affected like temperature and blood pressure regulation and may put one at the risk of autonomic dysreflexia which can be severe.

Apart from these, spinal cord injury may also affect one’s sexual life by causing erectile dysfunction and changes in ejaculation and fertility among men and loss of sensation and feelings among women. Hence, it is important to be cautious about the health of the spine and protect it from any sort of injury. Daily exercise, giving adequate rest to the spine, wearing appropriate shoes that support the spine, practising good ergonomics while sitting and keeping the body active can help a great deal in maintaining a healthy spine.

The author is consultant - neurosurgery, Head of Spine Services, Aster CMI Hospital

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