1.What is spinal cord injury? Spinal cord injury is a transverse damage to the spinal cord caused by various pathogenic factors (trauma, inflammation, tumor, etc.), resulting in impairment of spinal cord nerve function (motor, sensory, sphincter and vegetative nerve function) below the plane of damage. 2, the etiology of spinal cord injury? Spinal cord injury is actually not uncommon, and its causes are mainly threefold: first, traumatic. Traumatic injuries of various causes, as long as they involve the spinal cord, causing the spinal cord to be shocked, may cause spinal cord injury. The most common injuries are falls from heights; traffic accidents and direct impacts; and smash injuries, such as those caused by coal mine collapses and housing collapses. In addition to traumatic spinal cord injuries, there are a large number of other non-traumatic spinal cord injuries, and there is a tendency to increase them, such as: myelitis, spinal cord tumors, spinal cord vascular disease, spinal cord lateral sclerosis, etc. Of the two causes of spinal cord injuries, traumatic ones occur more often, but both are on the rise. According to a recent Beijing statistics, in the 1980s, the rate of spinal cord injury due to trauma was 6.8 per million, while now it is 60 per million, an increase of many times. 3.How should the first aid scene be handled in case of spinal cord injury? If there is a wound, should be emergency bandage, and should not easily turn the casualty, there is cerebrospinal fluid leakage to thicken the bandage. For those with breathing difficulties and coma, oral secretions should be cleared in time to keep the airway open. First aid handling process, must pay attention to keep the casualty’s head and neck and torso straight position, never make the spine flexion and twisting. Especially cervical spine injuries, should be carried more carefully, and fixed. Do not lift the head, torso or sit up. It is best to use a flat stretcher or door plate. When there is a wound or possible infection, antibiotics should be applied reasonably. Also, prevent and treat other site injuries and prevent urinary tract infections and respiratory complications. In cases of high paraplegia, tracheotomy should be performed early if necessary; when carrying for a longer period of time on the way, hard objects in the casualty’s coat pocket, etc., should be removed to prevent pressure from decubitus ulcers. After emergency treatment, the patient should be sent to hospital immediately for treatment. 4.What is the main function of the normal spinal cord? The spinal cord is a link between the brain and peripheral nerves. The brain’s commands are transmitted to peripheral nerves through the spinal cord, thus completing the body’s motor, sensory and bowel control functions. 5.What happens after a spinal cord injury? After spinal cord injury, its ability to transmit brain control motor and sensory commands is reduced or even lost, resulting in corresponding pathological changes such as sensory and motor impairment, abnormal reflexes and incontinence or retention of urine and stool below the plane of injury, which are often referred to as “quadriplegia” (referring to cervical spinal cord injury) and “paraplegia “(refers to the thoracic and lumbar spinal cord injury). 6.What is incomplete spinal cord injury and what is complete spinal cord injury? Incomplete injury: If it is found that some sensory and motor functions are retained in the sacral segment below the plane of the injured nerve including the lowest position, this injury is incomplete damage, and the sacral sensation includes the anal mucosal skin junction and the deep anal sensation. Motor function examination is performed by anal examination with a finger to determine whether there is active contraction of the external anal sphincter. Complete injury: refers to the complete loss of sensation and motor function of the sacral segment. 7.What is the age distribution of spinal cord injury patients in China in terms of morbidity? The average age of traumatic spinal cord injury is probably around 30 years old most often. One is young adults, who are more involved in sports, and the other is people aged 50-60, who mostly suffer from spinal cord injuries due to falls. Therefore, the age span of spinal cord injury jumps from young adults to the elderly, with relatively few middle-aged people and fewer children. 8.What is the incidence of spinal cord injury? The incidence of traumatic spinal cord injury is about 60 per million. In total, the literature reports a rate of 6 to 20 per 100,000. In China, about 70,000 to 80,000 new spinal cord injuries occur each year. Combined with an average life expectancy of about thirty years after injury, the cumulative number of spinal cord injury patients is a significant number. 9.Why should special emphasis be placed on rehabilitation for spinal cord injury patients? Once the spinal cord is stabilized, there will be primary dysfunction, such as paralysis, and secondary dysfunction, such as stones in the kidney system, pressure sores, joint dysfunction, sexual dysfunction, and fertility problems, because there are fewer opportunities to promote spinal cord nerve regeneration, fertility problems, etc. These cannot be solved simply by medication or surgery, but must be improved, compensated and replaced by certain rehabilitation training, so that spinal cord injury patients can regain their self-care ability and improve their quality of life as much as possible, which is very important. 10.The purpose of rehabilitation for spinal cord injury? Rehabilitation can largely prevent or reduce a series of serious complications caused by spinal cord injury, such as pulmonary infections, urinary tract infections, pressure sores, joint stiffness and contractures, postural hypotension, deep vein thrombosis, mental depression’s, etc. And through the assembly and use of assistive devices, the patient can maximize the recovery of activities of daily living and work, learning and recreation and other abilities. 11.When does the rehabilitation treatment of spinal cord injury usually start? The earlier the rehabilitation treatment is, the better. It can be started once the clinical situation is stable, for example, after spinal surgery and not in the process of resuscitation. The early rehabilitation process is not taking very complicated measures or strenuous exercise, and can prevent some comorbidities, so the earlier the better. 12.The relationship between spinal cord injury plane and functional prognosis? Plane force Mobility Life ability Cervical spine 1-4: dependent on diaphragmatic pacing to maintain respiration; available to manipulate certain activities in a voice-activated manner; completely dependent. Cervical spine 4: uses a power high back wheelchair; sometimes requires assisted breathing; highly dependent Cervical 5: Hand-driven high-back wheelchair on a flat surface; requires upper extremity aids; mostly dependent. Cervical spine 6: can drive wheelchair by hand; wears tops independently and can drive specially adapted cars; moderate dependence. Cervical spine 7-8: wheelchair functional; can do bed-wheelchair/toilet/bathroom transfers independently; mostly self-care. Thoracic spine 1-6: wheelchair independent; walk short distances with a long-legged orthotic; mostly self-care. Thoracic spine 12: walking with a long-legged orthosis to support crutches; wheelchair required for long-distance mobility; mostly self-care. Lumbar spine 4: walking with a short-legged orthosis holding a cane; no need for a wheelchair; basic self-care. 13.How to do some effective rehabilitation training in the early stage? The earliest training can be done shortly after surgery or after a traumatic injury. There are two things that are most important: First, to protect all joints, at least once or twice a day to do full joint range of motion, the range should be complete, each joint should be moved to avoid joint contracture. The second is to prevent postural hypotension, because long-term bed rest will stand up dizzy, to let the patient gradually elevate the head of the bed, from 30 degrees, 40 degrees, 50 degrees, 60 degrees, gradually elevate, of course, elevation can not let the patient sit up by themselves, to use the shaking bed, because the spine does not have any movement, so elevate the head of the bed is early can do. 14.How to do muscle training and exercise? The muscle strength training in the acute period is to prevent muscle strength loss and muscle atrophy during bed rest; the muscle strength training in the recovery period is to help obtain various movements and functions, methods include: upper limb muscle strength strengthening training and lower limb active assistance training with iron dumbbells etc. for thoracic and lumbar medullary injuries, training with weights, pulleys, rubber bands or freehand resistance method for cervical medullary injuries, and more important methods include sitting training and bracing movements. In addition to muscle strength training, joint mobility must be maintained to prevent contractures. The acute phase is mainly performed passively, while the recovery period is left to the patient’s own activities.