Question

topic: spinal cord injury. i need to write atleast 10 pages of paper. this includes the following info i need.

1 Introduction,

2 definition,

3. 2 theoretical perspectives,

4. how concept has changed over time,

5. current practice,

6. policy issues,

7. conclusion,

8 compare U.S. vs 3rd world country,

6 references

Answer 1

Introduction:

Spinal cord injury (SCI) is a traumatic event that results in disturbances to normal sensory, motor, or autonomic function and ultimately affects a patient’s physical, psychological, and social well-being.

It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.

The condition often causes permanent changes in strength, sensation, and other body functions below the site of the injury.

Motor vehicle accidents, acts of violence, and sporting injuries are the common causes of spinal cord injury.

Spinal cord lesions are classified as a

complete ,that is total loss of sensation and voluntary motor functionfunction, or

incomplete ,that is fixed loss of sensation and voluntary motor function.

They are classified as follows:

C-1 to C-3: Tetraplegia with total loss of muscular/respiratory function.

C-4 to C-5: Tetraplegia with impairment, reduced pulmonary capacity, complete dependency for ADLs.

C-6 to C-7: Tetraplegia with some arm/hand movement allowing some independence in ADLs.

C-7 to T-1: Tetraplegia with limited use of thumb/fingers, increasing independence.

T-2 to L-1: Paraplegia with intact arm function and varying function of intercostal and abdominal muscles.

L-1 to L-2 or below: Mixed motor-sensory loss; bowel and bladder dysfunction.

Definition:

According to WHO, The term ‘spinal cord injury’ refers to damage to the spinal cord resulting from trauma (e.g. a car crash) or from disease or degeneration (e.g. cancer).

OR

Acute spinal cord injury is defined as sudden onset damage or trauma to the spinal cord resulting in loss of tissue integrity, which can lead to impaired function, reduced mobility or sensory dysfunction.

Current practices (advancements in the year 2020)

*medications

Methylprednisolone

Several neuroprotective and neuroregenerative pharmaceutical drugs have been investigated for SCI management. A well-known neuroprotective agent, methylprednisolone, has been associated with improved neurological outcomes. It decreases the peroxidation of membrane lipids and posttraumatic inflammation.

Minocycline

Minocycline, a modified form of tetracycline, is another neuroprotective agent that has shown some promise in animal models.

Riluzole

Riluzole, a sodium channel blocker approved for the treatment of amyotrophic lateral sclerosis, has been studied in preclinical models of SCI. It diminishes secondary injury by blocking activation of sodium channels and reducing release of neuronal glutamate.

Cethrin

Cethrin is a permeable paste that can be applied to spinal cord dura postinjury that is a combination of a bacterial-derived toxin, BA-210, and a biohemostatic adhesive. It inhibits the Rho pathway of inhibitory proteins and promotes axonal growth in vitro.

Anti-Nogo

Another neuroregenerative drug, anti-Nogo, is a monoclonal antibody made to bind to Nogo-A, and has been shown to promote neural regeneration.

GM-1 ganglioside (Sygen)

A neuroregenerative agent, GM-1 ganglioside (Sygen) has been shown to enhance axonal regeneration in laboratory studies.

*Stem cell-based therapies

Phase I clinical trials have demonstrated that transplantation of olfactory ensheathing cells can be a safe, promising option to aid in neuronal repair in patients with SCI, but more Phase II clinical trials are still needed.

.In vitro manipulation of the embryonic stem cells (ESCs)

This include oligodendrocyte- induced remyelination, axonal elongation, and tract regeneration. However, legal and ethical drawbacks have limited the employment of ESC in the treatment of SCI patients. This might be largely attributed to the destruction of the blastocyst on isolation of the cells.

*Prosthetic devices

Robotic exoskeletons or powered exoskeletons have emerged as an advantageous rehabilitation tool for certain disabled individuals with SCI. The studies provided preliminary evidence on efficacy of exoskeletons on cardiovascular health, energy expenditure, body composition, gait parameters, level of physical activity, neuropathic pain level, and quality of life. They can be used to restore a certain level of physical activity years after injury.

*Neuromodulation

It is well known that neuromodulation, the use of electrical stimulation to alter neuronal circuitry, has been tried in various neurological disorders including SCI.

.Activity-dependent plasticity

Moreover, the concept of activity-dependent plasticity has been recently employed to achieve substantial improvements in motor function, based on the recent finding that neurorehabilitation is the only treatment option which can be offered to SCI patients for long-term improvement in motor function.

.Spinal cord stimulation

With respect to spinal cord stimulation, epidural spinal stimulation has well been tested in patients with chronic pain and most recently in patients with SCI. This method involves surgical placement of electrodes onto the dorsal surface of the spinal cord.