The spinal cord vibration or commotio spinalis is the easiest stage of the spinal cord injury and occurs, for example, in the context of accidents. In contrast to the more severe forms, no spinal cord lesion can be detected in the spinal commotio in the radiological examination. Complaints such as micturition disorders or reflex failures subside by themselves about 48 hours after the incident.
What is spinal commotio?
The spinal cord is part of the central nervous system and, with its pyramidal tracts, plays an important role in controlling human movements. Spinal cord trauma is damage or injury to the spinal cord or its surroundings, which is often associated with impaired movement control.
Basically, damage to the spinal cord is divided into three different stages, which differ in their severity. In addition to the spinal cord contusion (Compressio spinalis), there is also a spinal cord contusion (Contusio spinalis). The mildest stage of the spinal cord injury is the spinal cord vibration, which is also known as the commotio spinalis.
In contrast to the other stages, this stage of the spinal cord injury is characterized by only temporarily predominant failure symptoms in neurological stimulus transmission, which can be attributed to the action of mechanical force.
Causes
Commotio spinalis is caused by a physical mechanical force on the spine. In most cases, the spinal cord tremor is caused by short-term and indirect violence on the spinal canal of the spinal cord. This type of violence can occur, for example, in a car accident, an accident at work or a sports accident.
The decisive factor is the time limit for the impact of violence. In the event of prolonged or direct violence on the spinal cord, a spinal cord contusion or spinal cord contusion is more likely than a spinal cord tremor. In contrast to the other two stages, no manifest injury to the spinal cord can be demonstrated in the case of a spinal cord vibration.
In other words, the brief exposure to violence did not leave any verifiable traces, but can only be guessed based on the symptoms.
Symptoms, ailments & signs
The exact symptoms of the commotio spinalis depend on the one hand on the severity and on the other hand on the exact location of the violence. Light acts of violence lead to emotional disturbances, especially in the area of the extremities.
Medium-class violence can be associated with a disturbance of the reflex function or micturition disorders, while with strong violence on certain areas of the spinal cord, manifest symptoms of paralysis of the extremities are also conceivable.
In contrast to spinal cord contusion and spinal cord contusion, all symptoms of spinal cord tremors subside by themselves after 48 hours at the latest. In most cases, those affected only suffer from mild pain. Often those affected show further trauma, since the spinal commotio is usually the result of an accident.
Diagnosis & course
The diagnosis of a commotio spinalis is made by a neurologist. When diagnosing it, it is important to distinguish it from other stages of the spinal cord injury. In addition to taking the medical history, the neurologist conducts a reflex examination. The failure of reflex physiological movements can indicate a spinal cord injury.
The same applies to reflex pathological movements with a corresponding anamnesis. The distinction between the commotio spinalis and other spinal cord injuries can only be achieved through imaging. A radiologically visible spinal cord injury is not a spinal commotio.
If the spinal cord appears to be radiologically intact, but there are still reflex deficits or similar symptoms, the diagnosis of spinal cord vibration is an obvious one. The prognosis for patients with spinal cord vibration is favorable. Irreversible damage does not occur.
Complications
In most cases, reflexes fail and paralysis occurs in the spinal commotion. As a rule, these do not occur immediately, but rather after a time delay after the accident. The spinal commotion leads to relatively severe sensory disturbances. These can occur in different parts of the body and thus restrict movement and generally the everyday life of the person concerned to a relatively large extent.
The extremities can be paralyzed, so that the person affected is dependent on a walking aid or a wheelchair. It is not uncommon for pain to occur as well. The symptoms of the commotio spinalis do not last permanently, but in most cases disappear again after a few days, so that there are no permanent complications or restrictions. Complications can arise mainly from the accident.
If the symptoms and the pain of the commotio spinalis do not go away on their own, treatment with painkillers or therapies is necessary. This usually leads to success and further complications do not arise. It is not uncommon for patients to have to be given psychological support after the accident in order to deal with the accident and the consequences of it.
When should you go to the doctor?
In most cases, this complaint does not require any special medical treatment. However, complaints from this doctor should be examined by a doctor, especially after an accident, in order to avoid further complications and possibly permanent paralysis. A doctor should then be consulted if there are disorders of sensitivity or various types of paralysis in the patient’s body. These can occur in different regions.
The affected person’s reflexes are also negatively affected and can be significantly restricted. A medical examination is particularly necessary if these symptoms do not subside on their own within 48 hours. Usually the disease can be diagnosed on a radiological examination. First and foremost, however, a visit to a general practitioner is required. If the complaints and symptoms go away on their own, no special treatment for this disease is usually necessary and the disease progresses positively.
Treatment & Therapy
Above all, the spinal cord vibration requires rest. The patient ideally stays calm for the next few days and enjoys bed rest. Since the symptoms subside after two days, no further treatment is usually required. This relationship distinguishes spinal cord concussion from other stages of spinal cord injury.
Since the patient can suffer from more or less severe pain even with a spinal commotion, in addition to therapeutic protection, conservative drug treatment with painkillers is an option. However, this procedure is only indicated if there is actually severe pain and the quality of life of the person affected is clearly impaired by the pain symptoms for the next few days.
Mild pain can generally be a good indicator of the prevalence and subsidence of the shock. Once the mild pain has subsided, this is an indication of the patient’s full recovery. The reflex examination should be repeated after 48 hours.
If there is still pathological reflex behavior, further imaging may be indicated. In rare cases, more severe spinal cord injuries do not show up on the initial imaging and only develop to their actual extent in the days after the violence.
If the imaging after 48 hours still does not provide any evidence of an actually manifest spinal cord injury, but neurological deficits persist, there may be a psychosomatic cause. In this case, the patient is instructed to deal with the accident situation and its consequences in psychotherapeutic care.
Outlook & forecast
The prognosis for the spinal commotio is favorable. The symptoms are not permanent and gradually subside within a few days. The self-healing powers of the person become active and alleviate the symptoms without further intervention by a doctor.
Depending on the severity of the damage, the healing process can last for one to two weeks. Afterwards there is usually no symptoms. As soon as the patient adheres to the specifications and the instructions of the doctor, he will notice a significant improvement in his well-being after just 48 hours.
Permanent impairment is not to be expected with the spinal commotion. Consequences also only occur in very rare cases. They are mostly based on further violence or disregard of the medical guidelines. The patient needs a few days of rest and rest to heal. If more intense physical activity occurs during this time, health may deteriorate and the symptoms increase.
Vibrations in particular are to be avoided so that the good prognosis is maintained. If the patient suffers from a sequela, then it is usually tied to the cause of the force or violence. The triggering event can lead to sleep disorders, nightmares, trauma, or an anxiety disorder.
Prevention
A spinal commotio can only be prevented to the extent that the effects of violence on the spinal cord can be prevented. Since accidents can never be completely ruled out, preventive measures are limited. Nevertheless, studies show that a trained back is more likely to deal with the effects of violence unharmed than an untrained back.
For this reason, back training or attending a back school can make sense as a preventive measure in connection with the commotio spinalis. Anyone who has problems with their intervertebral discs, for example, is all the more susceptible to spinal cord tremors or even the more severe stages of spinal cord injury in an accident situation. For this reason, as far as possible, all efforts to improve back health are regarded as preventive measures for spinal cord injuries.
You can do that yourself
Independent measures for healing can only be carried out to a limited extent in the case of spinal cord tremors. Self-help in this disease is therefore geared towards a supportive influence in the recovery process.
Sufficient rest, protection and only a low load on the back help so that the symptoms can be alleviated as quickly as possible. The conditions during night sleep should be viewed critically and, if necessary, optimized. The back needs a healthy sleeping position so that the healing process is promoted. Jerky movements of the upper body are to be avoided as a matter of principle.
Likewise, the body should not be exposed to vibrations from hopping, jumping or running. Slow and steady movements are recommended. In terms of posture, care must be taken to ensure that there is no tilted posture or incorrect one-sided stress. This puts unnecessary strain on the skeletal system and can impair the supply of muscles, nerves or tendons.
In the case of leisure activities and sports, it should be checked whether these are beneficial during the recovery process. Visiting the rides at an amusement park, as well as participating in ball sports or fitness training, is not recommended. Exercises or environments that encourage relaxation are helpful. This strengthens the well-being and prevents the back from being exposed to unnecessary strain. In addition, the immune system can be supported with a healthy diet.
