Spine InjuriesDr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
Comprised of 26 vertebrae, or bone discs, the structure of the human spine is such that it allows individuals to stand, bend, move and participate in numerous activities. Yet, injuries and problems can change the structure of the spine, resulting in damage to the intervertebral discs and surrounding soft tissues. For the most part, medical professionals refer to spinal injuries as either complete or incomplete.
A complete spinal cord injury happens when the spinal cord is completely severed. In this case, functioning is fully eliminated, though therapy has proven that individuals can regain some level of functioning with time. On the other hand, incomplete spinal cord injuries account for roughly 60% of all spinal cord injuries and describe a condition where the spinal cord is partially detached.
Incomplete spinal cord injuries are further classified into the following types:
- Anterior cord syndrome: Is an injury to the front of the spinal cord, causing damage to motor and sensory pathways. Though individuals retain sensation, they experience trouble with movement.
- Central cord syndrome: Is an injury to the center of the spinal cord, resulting in damage to the nerves responsible for carrying signals from the brain to the spinal cord. Individuals may experience impairment in leg movements, loss of fine motor skills, paralysis in the arms or a loss of bowel or bladder control and sexual functioning.
- Brown-Sequard syndrome: Is an injury to one side of the spinal cord, eliminating movement on one side of the body. This type of injury varies from individual to individual, depending on the extent of the injury.
To aid in the diagnosis and treatment of spinal cord injuries, medical professionals typically label injuries, according to their location on the spine. Consider the following common types of spinal cord injuries:
- Tetraplegia: As the most severe type of spinal cord injury, tetraplegia or quadriplegia, occurs following damage to the cervical spinal cord. In essence, tetraplegia results in paralysis of all limbs, though some cases are more pronounced than others. Often, individuals lose their ability to move below the site of the injury and may encounter problems with bladder and bowel control, as well as respiration. When injuries occur higher on the cervical spinal cord, symptoms are more severe.
- Paraplegia: When an injury is sustained at the thoracic (mid-back) level of the spine, individuals lose sensation and movement in the lower part of the body and legs. As with cervical spinal cord injuries, symptoms become more debilitating when the injury occurs in a higher section of the spine, near the top vertebra.
- Triplegia: Often associated with an incomplete spinal cord injury, triplegia results in loss of sensation and movement in one arm or both legs.
Interestingly, injuries sustained below the lumbar spinal cord do not result in paralysis or problems with sensation. However, they do cause pain, discomfort and weakness, as well as problems with bladder and bowel control and sexual function.
Symptoms of Spinal Cord Injuries
When it comes to spinal cord injuries, they are distinctly different from chronic back pain or degenerative disc disorders. With these injuries, pain may come and go or travel to lower extremities. Rather, they are easy to identify, and most understand that they are serious. Even so, the following are common symptoms associated with injuries to the spinal cord:
- Paralysis (tetraplegia, paraplegia)
- Loss of bladder function
- Difficulty breathing
- Chronic pain and headaches
- Chronic muscle pain
- Nerve pain
- Pneumonia (more common with cervical spinal cord injuries)
Treatment and Rehabilitation for Spinal Cord Injuries
Physiatrists are in a special position to bring multidisciplinary treatment and rehabilitation to patients with spinal cord injuries. Particularly for those with a traumatic spinal cord injury (SCI), treatment plays a vital role. Physiatrists often consult other medical professionals to develop a comprehensive plan for pain management and avoiding secondary complications. In turn, physiatrists will determine if there is a psychological component relating to the patient’s injury. For many spinal cord injuries, counseling proves helpful as patients deal with emotional concerns and perhaps cognitive dysfunction.
With a highly integrated approach, physiatrists work to optimize patient care, empowering patients in their recovery. Through continued advancements in care, the following may be used to enhance recovery:
- BSWT (Body weight supported treadmill testing) – improves stepping or walking
- Electrical stimulation – used to address muscle atrophy and increase cardiovascular functioning
- Robotic therapy – to improve motor function
- Advanced wheelchair seating
- Medication – to reduce muscle stiffness and tightness
- Ventilator management – to help patients overcome respiratory concerns
- Patient education – may include support groups and family counseling
At the Howard Liss, M.D. Rehabilitation Institute, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.
For appointments, contact the Howard Liss, M.D. Rehabilitation Institute today.