Spinal injuries – A danger to overall body functioning
The spinal cord is one of the most essential components of our central nervous system. It is a well-known fact that the spine acts as a communication system to transmit messages between the brain and other parts of the body. Any damage or injury to the spinal cord can end up in messing up with this circuit of message transmission.
In order to realize how our body can get affected by a spinal cord injury, it is important to know how the spine works. Several nerves originate from the brain and reach the skin, muscles and body organs through the spinal cord. There are specific levels on the spinal cord from where each nerve enters the cord and leaves it while entering to other body parts. The first seven levels known as the cervical levels are responsible for controlling breathing, neck and arm function. The next twelve levels or the thoracic levels control the chest and torso areas. The five lumbar levels manage the legs and the sacral levels are responsible for bowel, bladder, sexual and leg functions. It is, in fact, the spinal cord that controls our body movements. Thus, damage or injury to the spinal cord may damage the movements and functions of the above-mentioned areas in our body.
How can spinal cord injuries affect body functions?
A spinal cord injury is probably one of the most devastating injuries to a person, not only in terms of the physical disability it can produce but also in terms of its social and psychological implications on the injured person as well as his family. A person with a spinal cord injury can develop several ‘secondary’ complications and issues which need to be addressed from time to time.
Skeletal system: This is one of the body systems that get primarily hit due to a spine injury. Following an injury, some calcium and minerals leave the bones which may gradually get accumulated in the urinary system causing stones. This is why it is advised to remain as much active as possible post a spine injury. Difficulty in movement may result in joint stiffening of knees, elbows, shoulders and may cause pain. Range of Motion (ROM) exercise is of great help by enabling complete movement of joints by correct positioning in bed.
Urinary tract system: Many times, a person with spinal cord injury will not be able to empty his bowel and bladder. In such situations, either a person has to be on a full-time urinary catheter or has to do intermittent self-catheterization. In either of these situations, there is a substantially increased risk of urinary tract infections (Manifests as burning micturition, lower abdominal pain and fever with chills); that need to be treated with antibiotics. Preventing such infections by following hygienic and sterile catheterization techniques is always helpful.
Bowels: Similar to urinary issues, many patients with spinal cord injury also have a difficulty in emptying their bowels resulting in constipation. The abdominal muscles may have to be put on use to push the stool out depending on the extent and level of spine injury. A spinal cord injury can thereby result in bowel accidents, constipation and impaction. Following a spinal cord injury, it is essential to re-train the bowels. A new routine with various techniques, methods and medication, with the help of a gastro-enterologist and a physiotherapist, may help in regaining normal bowel movement and keep bowel accidents at bay.
Skin: The spinal cord sends messages to the skin to protect it from being hurt. Once the spine is injured or damaged, the transmission of these signals may pause and the skin may become numb to certain feelings of discomfort. Also, these patients usually have limited mobility and are confined to bed/ wheel-chair most of the time, increasing pressure on certain points on the skin. It can lead to pressure sores that open the skin to germs which may enter the body and enhance the risk of developing several infections. Daily skincare, regular skin check-ups and avoidance of pressure points by frequent change in positioning can help in these situations.
Respiratory system: Respiratory system may also get affected by a spinal cord injury. The very ability to move air in and out of the lungs depends on muscles which are controlled by the nerves in the spine. An injury to the spine may affect the ability to cough or even take deep breaths which are ways of ensuring complete and healthy functioning of the lungs. An incentive spirometer, a tool that enables deep breathing may come to the rescue and artificially help to take deep breaths. Regular chest physiotherapy and breathing exercises along with early recognition and prompt treatment of respiratory problems can prevent major complications like pneumonia or respiratory failure.
Autonomic function: Spinal cord injury may affect autonomic functions as well. The autonomic nervous system that runs in and out of the spinal cord manages the glands, digestion, heart, temperature, blood pressure and more. A spinal cord injury may result in most of these functions getting affected like temperature and blood pressure regulation and may put one at the risk of autonomic dysreflexia which can be severe.
Apart from these, spinal cord injury may also affect one’s sexual life by causing erectile dysfunction and changes in ejaculation and fertility among men and loss of sensation and feelings among women. A spine injury can put the entire body function at stake and lead to abnormal functioning of several body organs and systems. Hence, it is important to be cautious about the health of the spine and protect it from any sort of injury. Daily exercise, giving adequate rest to the spine, wearing appropriate shoes that support the spine, practicing good ergonomics while sitting and keeping the body active can help a great deal in maintaining a healthy spine.
Authored by Dr. Umesh Srikantha, Consultant – Neurosurgery, Head of Spine Services, Aster CMI Hospital
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Karnataka Assembly passes bill on Palace Grounds amid opposition protest
Bengaluru, Mar 6 (PTI): The Karnataka Assembly on Thursday passed the Bangalore Palace (Utilisation and Regulation of Land) Bill, reaffirming state ownership over 472 acres and 16 guntas of land here, amid protests by the opposition BJP.
During the discussion, Karnataka Law and Parliamentary Affairs Minister H K Patil said the state government would have to provide Rs 200 crore worth of Transfer of Development Rights (TDR) for each acre of land, which means that for 15 acres, Rs 3,000 crore worth of TDR would be issued.
“If we accept it, then this 2-km stretch of road will become the costliest road in the world. If we accept it then how are we going to develop the city in later stages? How will you carry out development works?” asked Patil.
He also pointed out that this question was raised not only under the Congress government but also during the previous BJP regime.
However, the BJP-led cabinet has opposed the project.
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“Suppose we agree to it then, what will be the valuation of the 472 acres? It will be lakhs and lakhs of crores of rupees. Can we accept?” Patil wondered.
The Minister said the government had previously exercised its executive powers to issue an ordinance, which was approved by the Governor. Now the government is bringing a bill with two amendments.
“In this bill, we have made provisions either to develop or drop the road development work,” Patil explained.
However, BJP state president B Y Vijayendra and BJP MLA Arvind Bellad opposed the move, alleging that the government was targetting Yaduveer Krishna Datta Chamaraja Wadiyar, the scion of the Mysuru royal family, and the BJP MP from Mysuru-Kodagu constituency out of political vendetta.
“We talk of 472 acres of Mysuru Maharaja but here there are many Maharajas who too own 400 acres, 500 acres and thousands of acres of land, which is known to everyone,” Bellad said.
He slammed the Congress government, saying political power should not be misused for personal vendetta.
“Why (the then Deputy Chief Minister) Siddaramaiah brought the law in 1996 pertaining to the Bangalore Palace? Why are you setting eyes on the Bangalore Palace?” he asked.
Vijayendra charged that Wadiyar won the election on BJP ticket so the state government realised that it should acquire it.
“This bill has been brought for political vengeance. We are not discussing whether Rs 3,000 crore is exorbitant or not but the moment Yaduveer became MP, the state government woke up. You should be ashamed. This house should not be used for political vendetta,” he said.
Intervening, Minister Priyank Kharge said Vijayendra should not have raised it because the intention behind building the road was noble.
According to him, the BJP too had the same plan when it was in power.
He sought to know whether thousands of crores of rupees be spent on a road which should have cost significantly less.
In response, BJP MLA B A Basavaraj (Byrathi) said issuing TDR will not be a burden on the state government and appealed to the ruling Congress to reconsider its stance.
Minister Ramalinga Reddy too explained that the Karnataka government acquired the entire land way back in 1996.
The Mysuru royal family went to the High Court, which gave ruling in favour of the state government. The royal family then approached the Supreme Court, where the case is still going on, the Minister pointed out.
“The final judgment is pending in the SC to decide whether the acquisition was right or wrong. If the SC says it’s the royal family’s property then let it be so. If the order is in the state government’s favour then we can take a decision. The bill is only about it,” Reddy explained.
Speaker U T Khader then called for a voice vote and the bill was passed by the Assembly amidst opposition BJP’s discontent.
