Multidisciplinary Approach in the Treatment of Patients with Spinal Injuries

• Published in: Health science journal 2022-01, Vol.16, p.1-6
• Main Authors: Cordero, Jhon Fredy Bello, Carrascal, Antonio Maria Zumaque, Chávez, Ángel Fabián Leon, Graciano, Eucaris David, Bonilla, Jairo Alejandro Alonso, Caro, Luisa Fernanda Ospina, Cabra, Oswaldo Pérez, Lora, Juan Felipe Villegas
• Format: Article
• Language: English
• Subjects: Fractures; Immune system; Paralysis; Pathophysiology; Patients; Spinal cord injuries; Trauma; Traumatic brain injury
• ISSN: 1791-809X; 1791-809X
• DOI: 10.36648/1791-809X.16.S6.925

[...]the approach of a multidisciplinary approach is of vital importance for the treatment of a patient with a spinal cord injury in which pharmacological, surgical and physiotherapeutic aspects are considered relevant, carried out by a group of specialists with the aim of comply with a good management of patients in this condition. [...]it is important to recognize the different aspects that make up the treatment in order to present changes at the musculoskeletal level that improve the patient's quality of life in the long term. [...]endothelial damage leads to increased permeability and the presence of intracellular edema, this being an important factor for the extravasation of cells of the immune system [5], In turn, the evolution of this includes several phases: Trauma, in addition to producing neuronal death, causes glial cell lysis, destruction of blood vessels and injury to axonal tracts that, since they cannot regenerate, cause the alterations to be permanent [6], Regarding diagnosis, initially the patient's approach consists of evaluating the "ABCD", prioritizing airway patency, ventilation and circulation, establishing spinal immobilization measures in the required time, since airway management ventilation and the proper administration of mechanical ventilation is highly relevant to maintain homeostasis, by avoiding or reducing the risk of worsening the injury or the development of respiratory complications that together can generate morbidity and mortality by themselves [7], Subsequently, when the patient is stable, a neurological evaluation is performed. The evaluation of the patient will be carried out quickly and accurately through a clinical history that clarifies the probable mechanism of the injury, the state of consciousness and the existence of motor weakness at some point after the trauma [11], From a multidisciplinaryapproach, which includes several aspects of the treatment implemented in this type of patient, beginning with the pharmacological one, during which an initial dose of 30 mg/kg of methylprednisolone is administered, followed by 5.4 mg every hour, since it has shown to be beneficial for the recovery of motor and sensory functions, since methylprednisolone is capable of suppressing secondary neuronal death.