By Grundy, Beckinham, Andrew Haines, Anna Donald, David Grundy, Andrew Swain
Spinal wire trauma is almost certainly the main devastating final result of harm to the backbone. This well-established, useful advisor offers a close evaluation from the scene of the twist of fate to rehabilitation and discharge from health center care. This most up-to-date variation has been considerably rewritten to incorporate the newest advancements in sensible administration of sufferers with strength backbone damage and risk-minimisation options. there's additionally a brand new bankruptcy on spinal wire harm in constructing international locations.
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Additional info for ABC of Spinal Cord Injury
Complications of the procedure are irritatingly frequent though rarely life-threatening. Minor “plastic” procedures for stomal stenosis are required in up to 30% of cases and complete channel revisions for leakage or failure are necessary in 15%. The procedure may be undertaken in conjunction with bladder augmentation and/or bladder neck closure for intractable incontinence. 14 Bladder neck cuff—artificial urinary sphincter. 15 Self-catheterisation of a Mitrofanoff stoma. 39 ABC of Spinal Cord Injury Mixed faecal and urinary incontinence Further reading Cauda equina lesions causing sphincter weakness frequently result in mixed faecal and urinary incontinence.
Fractures of the atlas are of two types. The most common, a fracture of the posterior arch, is due to an extension-compression force and is a stable injury which can be safely treated by immobilisation in a firm collar. The second type, the Jefferson fracture, is due to a vertical compression force to the vertex of the skull, resulting in the occipital condyles being driven downwards to produce a bursting injury, in which there is outward displacement of the lateral masses of the atlas and in which the transverse ligament may also have been ruptured.
However, both suprapubic and urethral catheters should be discouraged where safer methods are available, especially in paraplegics. Above all, the merits of ISC should be stressed to the patient. In those men whose penis will retain a condom, sheath drainage is an extremely safe method of bladder management. Where necessary, endoscopic distal sphincterotomy is undertaken to abolish dyssynergia. Personal choice is now emerging as a major factor in planning, and the individual’s lifestyle preferences must be taken account of, though not at the expense of risk to the upper tracts.
ABC of Spinal Cord Injury by Grundy, Beckinham, Andrew Haines, Anna Donald, David Grundy, Andrew Swain