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إصابات النخاع الشوكي (كسور العمود الفقري)

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A spinal fracture is different from a fracture of the limbs, because the spine is the location of both the spinal cord and spinal nerves. Spinal cord injuries can be a result of lesser injuries to the ligaments or tendons, meninges (spinal membrane), spinal fractures, compressions, dislocations, and also nervous system injuries, which can in some cases cause paralysis. 

Causes
Spinal cord injuries can be caused by many factors, such as road accidents (45%), falls from high places (20%), sports injuries (15%), violence (15%), and other activities (5%). Osteoporosis and spinal tumors can also cause spinal fractures. These conditions account for 80% of spinal fractures in patients between the ages of 18-25 years. As such, males are approximately four times more likely than females to experience spinal fractures.
Symptoms will depend on the severity and location of the spinal cord injury. Individuals who present with spinal cord injuries may experience neck pain, back pain, or pain in other affected areas, as well as lack of sensation (numbness), muscle tension, fatigue, and incontinence. Some people can also experience paralysis, which indicates an injury to both the nervous system and spinal cord.  
Patients who have been involved in serious accidents, and present with the symptoms listed above, will need to be cautious with their range of movement, and will also require extra physical support such as wearing a back brace. After conducting a comprehensive physical examination of the patient, the doctor will issue a suitable diagnosis and treatment plan, such as a CT or MRI scan. An MRI scan is usually required in cases of suspected nervous system or spinal cord injury. 

Treatment will begin with the doctor prescribing medication for reducing pain, and protecting the injury from further damage with a back brace. The patient may also be required to wear a padded halo vest and a neck brace, and, in some cases undergo surgery, depending on the severity and type of injury.     

  • Wearing a back brace

A back brace is responsible for:

    • Supporting the spine at the point of injury.
    • Reducing the movement of the spine during recovery.
    • Reducing pain caused by movement of the spine.

For patients who suffer spinal fractures, or injuries which lead to loss of movement or nervous system injuries, a back brace must be worn for 8-12 weeks, or until the damaged vertebrae are healed. Such patients must also undergo physiotherapy.   

  • Discectomy and/or spinal fusion surgery
    In cases of spinal fractures which result in instability or dislocation of the vertebrae, treatment will be required to stabilize the spine. This may involve restructuring of the vertebrae, rearranging the vertebrae to fit their original positions, or fusing the damaged spine joints together. Restructuring the spine will also help to reduce pain and will help the nervous system to recover more effectively. Additionally, for patients with spinal fractures, a neck pillow will help to reduce pressure on the spinal nerves, as will surgery when complete.
  • Vertebroplasty and kyphoplasty
    Vertebroplasty and kyphoplasty are used in cases where the vertebrae have been compressed due to osteoporosis or certain types of tumor. Vertebroplasty is an injection of cement into the compressed vertebrae, while kyphoplasty is a method of raising the compressed vertebrae with a balloon prior to a cement injection.

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