IMMEDIATE MEDICAL PROCEDURES AND INTERVENTIONS
Spinal Immobilisation/Stabilisation : Right after the injury (at the scene or in the ambulance), the spine is immobilised to prevent any movement that could worsen the damage. The patient’s neck and back are kept straight, often using a cervical collar (neck brace) and a spine board. In the hospital, they may use devices like a rigid neck collar or traction tongs (e.g., Gardner-Wells tongs) to hold the neck in place if the cervical vertebrae are dislocated. You might see your loved one on a special bed or with their head secured to keep the spine aligned. High-dose Steroids : In some cases, doctors might administer high-dose methylprednisolone (a steroid) within the first 8 hours after injury. This was a common protocol intended to reduce inflammation and secondary damage. However, its use is controversial and not standard in all hospitals now because of mixed evidence and side effects. Don’t be surprised if you hear a discussion of steroid treatment – the medical team will weigh benefits vs. risks. Ventilation support: If the injury is high in the neck (typically C1–C5), the patient may have difficulty breathing due to paralysis of the diaphragm and other breathing muscles. In such cases, they will be placed on a ventilator(breathing machine). A tube will be put into their windpipe (intubation) to help them breathe. Family should be prepared to see this in critical injuries – it can be temporary or, in very high injuries, sometimes long-term. Lower-level injuries usually don’t need a ventilator, but they might need supplemental oxygen initially if the chest muscles are weak. Surgery (Spinal Decompression and Fixation) : Emergency or urgent surgery is often performed to stabilise the spine and relieve pressure on the spinal cord. In this surgery, an orthopaedic or neurosurgeon will remove any bone fragments or slipped discs pressing on the cord (decompression). They will also fixate the spine with hardware (screws, rods, or plates) to hold the vertebrae in proper alignment. For example, if a vertebra is shattered, they may fuse the vertebrae above and below and insert metal rods to stabilise the spine. Early surgery (within 24 hours) is quite common if there’s cord compression; it can potentially improve outcomes or prevent any worsening. After surgery, the patient might wear a brace (like a rigid collar or TLSO brace for the trunk) for weeks while the spine heals. Traction: In some cervical injuries, especially dislocations, doctors might use traction to realign the spine. This could involve weights attached to a harness or tongs in the skull, gently pulling to reposition vertebrae. It’s an older treatment but is still used in some cases before surgery or if surgery must be delayed. In the early hours and days after an SCI, the medical team focuses on preventing further damage and stabilising the patient. Here are key interventions you should know:
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