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A Spinal Cord Injury is typically the outcome of a traumatic accident or injury. Processing what has happened is hard enough, and learning that one has lost all or most functionality can be almost impossible to deal with. The good news is that with prompt medical attention and a tailored rehabilitation program, even a Cervical Spinal Cord Injury can be manageable. Here, we offer a brief guide to this category of Spinal Cord Injury and the best treatment options to restore functionality.

Understanding Cervical Spinal Cord Injury

A Spinal Cord Injury (SCI) involves mutilation of the spinal cord that causes reversible or irreversible changes in its function. Symptoms may include the loss of muscle function, sensation, or autonomic function, in the parts of the body supplied by the spinal cord below the level of the injury. A Spinal Cord Injury may be fully curable, depending on which part of the spinal cord was affected. 

A Cervical Spinal Cord Injury is one that affects the top seven vertebrae (C1 to C7) of the spinal cord. As these are the closest to the brain, a Cervical Spinal Cord Injury tends to be the most serious type of SCI and can even be fatal. Treatment entails a customized regenerative rehabilitation program including Stem Cell Therapy, Physical Therapy, Occupational Therapy, and Speech Therapy

Symptoms of Cervical Spinal Cord Injury

Cervical Spinal Cord Injury symptoms tend to involve partial or complete loss of sensory function that is often permanent. There also tend to be several associated complications, especially involving the respiratory or gastrointestinal system. We examine the symptoms of injuries to specific vertebrae as follows:

Injury affecting C1 to C4 nerves:

  • Paralysis of the arms, legs, and trunk
  • Potential inability to breathe
  • Loss or impairment of the ability to speak
  • Loss of bladder / bowel control
  • Potential need for extensive or complete assistance for all daily activities
  • 24×7 personal care often required
  • May be able to move around in a motorized wheelchair

Injury affecting C5 nerve:

  • Partial or total paralysis of trunk, hands, and legs
  • Some movement ability in the arms and elbows
  • Impaired bladder / bowel control
  • Impaired speaking ability
  • Difficulty breathing
  • Extensive assistance needed for activities of daily living
  • Can get around with a motorized wheelchair

Injury affecting C6 nerve:

  • Paralysis of the hands, trunk, and legs
  • Able to bend wrists back
  • Impaired speaking and breathing ability
  • Impaired voluntary control of bladder and / or bowels
  • Can move in and out of bed and wheelchair with assistance
  • Can potentially drive an adapted car

Injury affecting C7 nerve:

  • Paralysis of the lower body
  • Typically able to move arms and shoulders
  • Typically able to extend elbows and fingers to some degree
  • Impaired voluntary control of bladder and / or bowels
  • Can perform most daily tasks independently but may require assistance with more complex tasks
  • Can potentially drive an adapted car

Doctors will conduct extensive tests on anyone who has survived a traumatic injury to check for a Spinal Cord Injury and to determine the location and severity of the injury. They will employ a variety of imaging tests, including an MRI, a CT scan, and an X-Ray, and also check for strength and sensation in the patient’s limbs.

Treatment for Cervical Spinal Cord Injury

A Cervical Spinal Cord Injury requires immediate treatment to address the swelling in the spinal cord and any fractures or dislocations. Steroids and anti-inflammatory drugs can help to bring down the swelling and thus reduce the risk of secondary complications around the injury. Doctors may also take precautionary measures to avoid blood clots or stool / urine retention.

Once the initial swelling has subsided, the recovery journey begins. Recovery focuses mostly on learning to use the non-paralyzed body parts to achieve as much autonomy as possible, with potential return of sensation to some parts over time. Typically, the patient will need to supplement Cervical Spinal Cord Injury treatment with extensive support for the rest of their lives. A tailored rehabilitation program will include the following:

  • Physiotherapy: This focuses on improving strength, flexibility, and coordination in the trunk and limbs. Physiotherapists will guide the patient through targeted exercises to improve functionality in the unaffected limbs and potentially restore some feeling in the paralysed limbs. Stretching is also vital for healthy muscle recovery.
  • Occupational Therapy: This focuses on improving fine motor skills and introducing assistive equipment as needed to perform the activities of daily living. For instance, the occupational therapist could recommend clothes with velcro fastenings for easier wear, or the use of special cutlery that are easier to grip.
  • Speech Therapy: A speech therapist will teach the patient special exercises that enable safe swallowing, breathing, and speaking. They will also teach them how to use communication devices if verbal communication is not an option.
  • Stem Cell Therapy: This is a revolutionary form of treatment that uses the patient’s own cells to replace the damaged ones at the site of the Cervical Spinal Cord Injury. Over time, this treatment can potentially restore functionality in the nerves and help people recover significantly or even fully. In particular, doctors are optimistic about a form of treatment called cellular regeneration, which involves the use of engineered stem cells that can specifically target neural regeneration.

Living with a Cervical Spinal Cord Injury

Losing one’s facility to take care of oneself and move around freely can be hard for anyone to process. Especially in the early days of Cervical Spinal Cord Injury rehabilitation, it can feel like things will never get better. However, cultivating a healthy mindset is key to recovery, as mental health is inextricably linked to physical health. Here are some tips on how to adjust better to life with a Spinal Cord Injury.

  • Find a counselor who has experience working with Spinal Cord Injury patients. Talk about how you feel and seek coping mechanisms to help you process better.
  • Some of your medications could be causing depression or anxiety as a side effect. Ask your doctor if you can modify the dosage or try different medications.
  • Ask at your place of work about accommodations they can provide you so that you can continue to hold your job.
  • Keep doing the things you love as far as possible, such as watching movies, reading, or ordering takeout from a favorite restaurant.
  • Keep your loved ones close, and don’t hesitate to take their help when they offer it.
  • Monitor your health carefully and report any new symptoms to your doctor immediately.
  • Get as much physical activity as you can, and eat a nutritious diet for optimal general health. 
  • Keep showing up for your rehabilitation sessions. Remember that the more effort you put in now, the better the results you will see down the line.

FAQs

  • What is C spine injury?

A Cervical Spinal Cord Injury is the most severe kind of Spinal Cord Injury and can affect one or both sides of the body. The higher up the injury is along the spinal cord, the more severe the symptoms.

  • What is the most common injury to the cervical spine?

Most Cervical Spinal Cord Injuries occur due to trauma from a motor accident, a sports injury, or blunt force. Conditions like osteoarthritis or cancer could also cause compression fractures along the spinal cord.

  • Why are cervical injuries life-threatening?

The cervical vertebrae are the closest to the brain, which is why a Cervical Spinal Cord Injury can lead to widespread loss of function and paralysis in the body.

  • How long do neck injuries take to heal?

Most neck strains take about a few weeks to, although more severe muscle strains could take as long as 12 weeks.

  • How do you treat a cervical spine injury?

The first line of treatment for a cervical spine injury involves stabilizing the neck and spine, which could involve the use of braces or neck collars. Often, doctors may also perform surgery to remove bone fragments or foreign objects in the spinal cord.

  • Can damaged spinal cord nerves heal?

While there is no direct way to reverse damage to the spinal cord, scientists are working on various treatments that can enable nerve cell regeneration or enhance the functioning of the nerves that are still healthy.

  • Can the spinal cord heal itself?

Unlike other parts of the body, the spinal cord cells cannot heal themselves. This is because scar tissue and various molecular processes following a Spinal Cord Injury hinder the regrowth of long nerve cells.

  • Can cervical nerve damage heal?

There is no direct cure for cervical nerve damage. Treatment focuses mainly on rehabilitation and improving the functionality of the healthy nerves.

  • What helps nerves heal faster?

An intensive treatment program, one that is a combination of regenerative medicine and rehabilitation, helps the process of nerve repair.

  • Why are spinal cord injuries so serious?

The spinal cord contains the nerves that transmit messages from the brain to the rest of the body. Damage to the spinal cord can thus lead to paralysis and loss of function in the organ systems. 

  • Why are spinal injuries permanent?

Spinal cord injuries directly damage the nerves that convey messages from the brain to the rest of the body. These nerves are unable to regenerate on their own, which is why damage to the spinal cord usually has permanent effects.

  • Does spinal cord injury affect the heart?

Spinal Cord Injury can damage the nerves that enable the heart to function properly. Even if the heart is not directly affected, patients with Spinal Cord Injury tend to be at high risk for heart disease.

In conclusion, a Cervical Spinal Cord Injury is a life-changing diagnosis, but there are many treatments and support programs out there to make it easier. Patients should keep themselves motivated by taking their loved ones’ help, talking to counselors, and engaging with other Spinal Cord Injury survivors for encouragement. Over time, one will adjust and develop new abilities to become as independent and fulfilled as possible.

Dr Na'eem Sadiq is a respected stem cell specialist at Plexus, and a prominent neurologist in Bangalore. He studied neurology and clinical neurophysiology in London, and worked with some of the most prestigious medical institutions in England, and the Middle East. He completed his MBBS at Bellary Government Medical College, and a postgraduate degree in psychiatry from NIMHANS in Bangalore.

Dr Na'eem has perfected his knowledge and expertise in Continuing medical education (CME), and training in tissue culture, Stem Cell Therapy, and neurology. Dr Na'eem Sadiq possesses an undying passion to improve people’s lives. This led to the creation of Plexus, a neuro and Stem Cell Research centre in Bangalore in neurosurgery, and neurorehabilitation.