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| SCI - Why so Different? | |
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History of spinal cord injury refers to times when it was described as a
disease not to be treated, and affected patients were left in jungles for
disposal. An era of scientific inventions and discoveries has made it
possible to understand many a perplexing question. As the understanding
improved, so did the further probing to hunt for the unknown in this field.
The world has thus far reached a stage of stem cell implantation and
implantation of computerized chip along with nerves, the basic question
still remains as to why spinal cord injuries are so different from other
injuries? The person who is affected by SCI has lost sensations, motor power and autonomic function below the level of the injured neurotome. So for him, the definition of somatic sensation changes, and conversion to visual sensation is another learning process. A visceral sensation gets changed to a severe autonomic dysreflexia. In no other disease known to mankind is the effect so vast and discreet in terms of deficit that, affected person has to live the life with no hope of neurological improvement and no sure end of miseries, no five year survival statistics to apply. The family of the patient also cannot fathom the depth of damage in the early phase of injuries and strong denial on the part of patient and family keeps them away from factual knowledge. This gives rise to a relative disbelief about each other. No other disease offers a spectrum this wide that the affected person can live a normal life span or can die of complications within a few months of injury. The mind of patient does not follow a set pathological or physiological diagnosis and the treatment for any stage can become very difficult. Even if a patient is fully rehabilitated, still he or she needs a permanent attendant anywhere he or she goes. Person can perform almost equal to another colleague and yet be counted as a 100% disabled, a paradox which still exists. For the medical fraternity this injury is worse than any known injuries as the expectation of recovery after neurological involvements are lesser than few. A doctor can count on his fingers the miracles which have happened in front of him in one year. From the most sophisticated to the basic centers in modern times still lack the conceptualization of SCI. finding out spinal injuries the day after the patient has undergone laprotomy is not an uncommon happening. The residual neurological deficit does not let the doctor diagnose appendivitis, cholecystitis, bowel obstruction and many other medical emergencies which can only are detected when they become catastrophic. The only answer is to sensitize medical practitioners, so that spinal injuries are not left out to become complications. Dr. Sunil Katoch Consultant Orthopaedic Surgery, ISIC |
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