Lesions of the spinal cord

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Lesions of the spinal cord are very heavy trauma, often accompanied by shock requiring the premises of the patient in the intensive care unit, resuscitation ward or intensive care.
On the etiology of the defeat of a spinal cord is divided into the following groups: 41) traumatic lesions (partial break of the spinal cord, bleeding in him - hematomyelia, full cross-break); 2) disease after suffering inflammatory processes (myelitis, arachnophilia and others); 3) state after surgery (removal of the tumor and intervertebral disks).
On character of a lesion of the spinal cord - paralysis - there are sluggish, spastic and combined (sluggish upper and spasticity of lower limbs).
Lesions of the spinal cord in the thoracic and lumbar regions are accompanied by paresis or paralysis of the lower extremities and pelvis, and in the cervical region - upper and lower limbs and the disorder of the functions of pelvic organs.
Traumatic lesion of the spinal cord are characterized by: the absence of all kinds of sensitivity in the underlying departments; quick gross violations of the blood and lymph circulation, leading to the formation of bedsores, accompanied by inflammation, swelling and fever; paresis or paralysis intestinal function; disorder of pelvic organs functions (menstrual disorders in women, lack of sexual function in men, dysfunction of the bladder); paresis or paralysis of limbs; complications associated with the severity of the lesion (pneumonia, sepsis, anesthetic, pielit, and others).
Treatment of spinal cord injury is in the hospital, at home and in the clinic.
Complex treatment of spinal cord injury include: the correct arrangement of the patient; timely surgical intervention (if shown); intensive care; prevention of the development of bedsores, contractures, stiffness in the joints, exaggeratedly stop; drug therapy; prevention of the development of concomitant diseases (pneumonia, cystitis, urosepsis and others); physiotherapy and massage; rational nutrition; timely prosthetics; physiotherapy (on prescription); sanatorium treatment.
In the basis of recovery of patients with lesions of the spinal cord lies early use of physiotherapy and massages, which contribute to the normalization of reflex activity, mobility of nervous processes, oppressed by trauma, spinal shock and weakness. Medical gymnastics increases the flow of afferent impulses in the brain cortex, the function of which weakened traumatic lesion of the spinal cord.
Physiotherapy appointed on the 2nd day of the injury or operational intervention, despite the severe condition of the patient. It is divided into 3 periods, the duration of which depends on the location and nature of damage, complications and concomitant diseases, General condition of the body.
The tasks of medical gymnastics in the first period are: the removal of the patient from a serious mental condition; restoration of proper breathing; normalization of blood and lymph circulation and metabolism; the recovery of bowel and pelvic organs; prevent the development of trophic disorders - decubitus; the prevention of the development of stiffness in the joints, contractures, vicious position of the limbs; the preservation tone neprilichno muscles and restore the tone of paretic muscles; the creation of compensatory motor skills (driving straight legs at the expense of the pelvis, i.e. pulling direct feet).
When conservative and surgical treatment of the patient is placed on a functional bed on your back or stomach, and every 2-3 hours change their position to avoid the development of stagnation and bedsores. Swollen feet 4-5 times a day leg raise 30-40 minutes To combat dangling feet under them enclose the reference boxes or cylinders. To prevent the development of contractures, stiffness in the joints paralyzed limbs every 2-3 h spend passive movements in joints in all directions, and treatment of functional position with frequent change of position of the limbs. To combat congestion in the lungs pay much attention to breathing exercises, not only during physiotherapy sessions, but in the period of rest between them. Perform 3-4 different breathing exercises in small dosage - 2-3 times each.
In the first period of exercise performed in the original position lying on the back or stomach, or on the side or standing on all fours (in one lesson one position-at the direction of the surgeon-traumatologist); physiological curve in lesson unimucronate; the pace of the exercises is slow and average; the breath of 1:1. In each lesson includes 75% of General developmental and breathing exercises and 25% special. Introductory and final part of two-thirds of time classes, and the main one - third. After 20-30 min make a break 5 to 10 minutes, after which perform passive development of the joints of the feet, and in case of injury of the cervical spine and hands. In the first 6 days of being conducted in sequence from the centre to the periphery (hips, knees, ankles, fingers; the shoulder, elbow, wrist joints, fingers), and then from the periphery to the center. In the first 2-6 days each exercise repeat 2 - b time. From the first day of the sick, teach abdominal breathing and the contraction of the abdominal muscles.