Inpatient stay to stabilise the bony situationIn principle, the surgical possibilities for a spinal cord injury are severely limited. After accidents, the aim is to stabilise broken vertebral bodies in order to prevent further damage. If the spinal cord is squeezed, the fracture is also operated on here in order to create space again and to get the swelling of the spinal cord under control. In the spinal shock phase, it is also important to monitor and stabilise cardiovascular function and other organ functions.
Conservative treatment methods
Regular positioning and medical treatmentFirst of all, it is very important to transfer the newly paralysed patients every two to three hours, position them correctly and, if necessary, use aids such as seat cushions. Such measures help to prevent muscle cramping and pressure sores. Permanent redness of the affected parts of the body is an important early sign. Although often no or only few complaints exist, a deep wound can develop quickly or there may already be pronounced tissue damage deep down, although the skin is closed. Any nerve pain is treated with medication, which reduces it by up to 80 per cent.
Bladder emptying via catheterSpinal cord damage usually leads to impaired bladder function (incontinence). In freshly paraplegic patients, the urinary bladder is able to store urine, but not to empty it. In order to avoid infections and overstretching the bladder, the bladder is emptied, for example, by using what is known as a PUFI catheter, which reaches through the abdominal wall into the bladder and thus drains the urine. In the event of complete paralysis, the bladder is emptied repeatedly over the long term using a thin disposable catheter. With a maximum fluid intake of 1.5 litres per day, this must be done about four to five times a day. After six to eight weeks, bladder pressure is measured for the first time.
In order to avoid further damage caused by bladder disorders, we recommend a urological check-up at least once a year.
Emptying of the bowelThe emptying routine is also used for the bowel – depending on whether a flaccid or spastic bowel is diagnosed.
A flaccid bowel leads to involuntary stool loss. The aim of the therapy here is a solid and shaped stool. The bowel is emptied while sitting or lying on the left side, for example via digital stimulation. In this form of stimulation, a finger or other aid is gently inserted into the rectum and moved in a slightly circular motion. This triggers a reflexive intestinal movement in the rectum, which presses the stool out. The stimulation is repeated every five to ten minutes, depending on the reflex reaction of the bowel, until the rectum is emptied.
In the spastic bowel, the stool is not automatically released due to the increased muscle tension in the pelvic floor and external sphincter muscle. The aim of the therapy is thus a soft stool. This is also achieved by means of digital stimulation and, if necessary, supported using suppositories or laxatives. The bladder and bowel team at Schoen Clinic offers special nutritional advice to improve digestion and prevent complications and obesity.