Few steps forward 

The government plans three specialised spinal injuries centres to aid people with loco-motor disabilities

August 02, 2013 11:33 am | Updated 11:33 am IST

To the rescue: Spine injury needs specialised rehabilitation. Photo: K. Ananthan

To the rescue: Spine injury needs specialised rehabilitation. Photo: K. Ananthan

The Centre is planning to set up three highly specialised spinal injuries centres across the country for treatment of people suffering from various kinds of loco-motor disabilities.

Spinal cord injury (SCI) is, perhaps, one of the most devastating ailments that can afflict individuals and the most severe form of loco-motors disability. There are no proper epidemiological studies on spinal injuries in India; however, conservative estimates suggest that the incidence of spinal injuries would be around 20 per million with 2,500 fresh cases added every year, often as a result of road accidents.

At present, there is no cure for spinal cord injury and the outcome depends on timely evacuation to an equipped spinal centre and that, too, in an appropriate manner from the site. It has been found that comprehensive rehabilitation can empower patients with spinal injuries to lead a full and meaningful life.

In India, there is no government assistance in the form of appropriate assistive devices and mobility aids, medicines and other equipment required for daily management of bladder and bowels, cost of hiring care-givers and hospitalisation expenses. Additionally, spine injury usually leads to unemployment, not only for the injured person but also for a care-giver from the family resulting to a financial disaster, apart from the emotional disruption of the family.

In rural India, and in rough terrains, where gainful employment opportunities are restricted for a wheel chair user, a non-earning injured person in a family places inexplicable financial burden on the other members.

The Department of Disability Affairs in the Ministry of Social Justice and Empowerment will set up these specialised centres, during the XII Five-Year Plan, on the lines of the Indian Spinal Injuries Centre (ISIC) in the Capital. It has written to the States inviting proposals for establishing these institutions.

The State Spinal Injury Centre will be a comprehensive rehabilitation centre attached to the district hospital of the State capital with dedicated 30 beds, of which eight would be earmarked for women.

ISIC in the Capital provides comprehensive rehabilitation management services to patients with spinal cord injuries and related ailments. This centre has been receiving support from the Department of Disabilities in providing 25 free beds for treatment of poor patients. In addition, ISIC provides five free beds to poor patients from its internal resources.

The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain down the mid back. The brain and spinal cord together make up the central nervous system. The spinal cord is the main pathway for communication between the brain and the rest of the body through the nervous system. The main functions of the spinal cord are movements, sensation, autonomic functions like bowel and bladder functions, sexual function, hemodynamic stability, temperature control and respiratory function.

An injury to the vertebral column can result in an injury to the spinal cord which can affect all or some of its functions below the level of injury. An injury to the spinal cord can change, either temporary or permanent, in its normal motors, sensory, or autonomic function. It is different from any other injury to the body because of the lack of inherent ability of neurons to regenerate effectively for functional improvement. It leads to lifelong disability.

Spinal cord injury can result from traumatic or non-traumatic causes. The traumatic causes are motor vehicular accidents — globally the leading cause. Fall from height is the next cause and violence has significantly increased in incidence globally in the last decade. It is the leading cause of spinal cord injuries in the underdeveloped countries. Additionally, improper body mechanics and postures during aggressive sports can also lead to sports injuries. Infections, tumours and congenital disorders are rare causes of non-traumatic spinal cord injuries.

Spinal cord injury management is the most expensive treatment as compared to that of any other ailment. It requires prolonged hospitalisation and life-long follow-up. Management and rehabilitation are important components of the treatment.

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