--Dr Gaurav Raj Dhakal
Spine fractures or spine injury occurs as a result of trauma to the bones (vertebrae) or ligaments of the spine. In Nepal, road traffic accidents and fall injuries account for the majority of spine trauma. However, gunshot injuries and industrial accidents are also on the rise. Recently, sports and stunt related spine injuries are also prevalent. This injury might affect only the bones, ligaments, spinal cord, the nerve tissue or a combination and sometimes can also result in a transient loss of power in the legs or the hands or permanent paralysis.
Spine injuries can be devastating to both the patient and the family members. Paralysis can result in loss of function and the person may be bed bound or wheel chair dependent. If, the patient is the only bread-winner then it may have grave consequences on the patient’s family. These injuries also have a tremendous impact on the society and the health care system of our country. In the United States alone, there are approximately 11,000 new spinal injuries per year and 80% of these patients are male.
Patients with spinal injuries and paralysis are prone to develop bed-sores, urinary tract infection, chest infection, depression, loss of calcium and osteoporosis and problem with continuation of family. Therefore, the focus of treatment has revolved around a holistic approach and care needs to be taken right from the time of injury to hospitalizing such a patient. When a person gets a spine injury, s/he should be transported to the hospital on a spine board with a collar around the neck. No attempt should be made to carry the patient from his hands and feet. Once in hospital care, a spine surgeon evaluates the patient and might order for x-rays and CT or MRI scan to assess the patient’s neurological status. The decision on operating or treating the patient conservatively is taken by spine surgeon after duly analysing the imaging reports.
Spine patients require good rehabilitation program and vocational training to get them back into some form of independent livelihood. Considering the difficulties faced by spine injury patients, the health care system has developed strategies to enhance their quality of life through various improvements ranging from lighter wheelchairs, accessible toilets, support centres and fertility programmes.
Many spinal injuries can be prevented. Safe and sober driving is one of the most crucial safety measures. Use of seatbelts is a must and to raise awareness about accidents and spine injuries driving schools should include this issue in their curriculum. Spear tackling in football play and diving head first in shallow water should be avoided. People should be discouraged from climbing trees and a strong emphasis should be made on wearing proper harness while working in high-rise buildings and construction sites. Precautions should be taken in factories to prevent such kind of injuries.
In spite of all the preventive measures, if injuries do occur then prompt visit to a spine surgeon is of paramount importance!
The author is a spine surgeon at Norvic International Hospital and can be reached at [email protected]