The diagnosis

If a spinal cord injury is suspected, the patient must be admitted to hospital immediately. There, the doctors make the diagnosis based on the patient’s medical history, which is often associated with a previous accident or back injury. The affected person shows signs of paralysis and pathological reflexes. The doctor can determine the height of the lesion by means of neurological examinations and with the help of so-called identification muscles. A computer tomography (CT) shows fractures and injuries of the spinal column, whereas the spinal cord itself can be better assessed by means of magnetic resonance imaging (MRI).

The treatment

In fresh paraplegia, the main cause is usually an accident. Patients with suspected spinal cord injury should be treated as absolute emergencies. If unconscious, the person affected must be ventilated to keep the circulation stable.

Until first aid arrives, it is important to move the accident victim as little as possible, otherwise the spinal cord can be damaged even further. The emergency doctor will position the patient with a splint and ensure that vital functions (breathing and circulation) are maintained. In hospital, the injured spine is treated surgically or conservatively with splints and subsequent immobilization of the patient.

During the entire hospital stay, intensive medical monitoring is carried out to minimize the risk of complications. Long-term treatment of the spinal cord syndrome is carried out with the aim of actively supporting the remaining movement options and strengthening movement sequences. There are special facilities that specialize in the treatment of people with paraplegic syndrome.

The rehabilitation of the patient is done with physiotherapy, occupational therapy and the use of positioning splints. Paraplegic patients are often dependent on a wheelchair. An important goal of the follow-up treatment is the reintegration of the affected person into his or her social and – if possible – professional life.

Since the disease is a heavy psychological burden for the patient, psychological stabilization is necessary, which is achieved through intensive psychological or psychotherapeutic care. Many patients take part in self-help groups. Many new treatment approaches are currently being investigated to heal paraplegic people.

Animal experiments have shown that the damaged nerves in the spinal cord can be renewed by the administration of stem cells. Another approach is the administration of cordaneurin, a drug that leads to the regeneration of nerve cells and has already shown initial success in preclinical studies. These results give hope that paraplegia, which has so far been considered incurable, can be successfully treated in the near future.Occupational therapy serves to strengthen residual functions and helps patients to integrate into everyday life.

Trained occupational therapists help the patients to relearn everyday tasks and movement sequences and thus reduce the need for care. A therapy strengthens the movement sequences, avoids incorrect posture and optimizes the patient’s handling of the wheelchair (e.g. by training the independent transfer out of the wheelchair and back in again). The physical condition of the patient can be significantly improved and the affected persons have the opportunity to lead a largely self-determined and independent life.

A paraplegic syndrome requires lifelong aftercare of the patient. The care of an acute paraplegic patient includes above all the treatment of the symptoms (e.g. bladder and rectal disorders), assistance with activities of daily living and frequent repositioning to avoid the patient’s bedsores (med. decubitus).

Especially at the beginning of the disease, most patients are not only physically but also psychologically severely affected and feel overwhelmed by the situation. Psychological support is important here so that the patient does not become depressed or have unrealistic hopes. Due to the injury to the spinal cord and the associated symptoms, patients have problems coping with their everyday life. Usually, the affected persons are classified into a care level and receive care allowance, which can be applied for at the insurance company. In the presence of a paraplegic syndrome, the affected person is considered severely disabled and has the right to a severely disabled pass and the associated benefits.