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Spinal cord injury

Spinal Cord Injury

Spinal Cord Injury (SCI) is an injury to the head and the spinal cord caused by trauma or destructive pathologies such as tumors that cause compression and deformity on spinal cord.  Left untreated this can lead to neurovascular deterioration, reduced blood supply and oxygen supply (ischemia and hypoxia), swelling and consequent degeneration of nerve cells (neurons) leading to Paraplegia and Quadriplegia.

“I was declared quadriplegic after my accident."
"Now, after hyperbaric I am driving my car.”  -  A.R. Parksville


Testimonial: Motor vehicle accident with SCI end result

Hello, my name is Ryan Clarkson and I am an incomplete paraplegic.
I went from a wheelchair to walking with a cane with a help of oxygen therapy
"
 -  Ryan C, Vancouver

 

Hyperbaric oxygen therapy can reverse neuronal damage by providing immediate high oxygen levels to injured nerve tissue. Sufficient oxygen can activate anatomically intact but dormant neurons in the penumbra zone, zone with diminished tissue oxygenation surrounding infarct (dead) cells.  Hyperbaric oxygen relieves ischemia of the grey matter of the spinal cord and reduces swelling of the white matter.  Increased oxygen levels in the cerebral spinal fluid correct biochemical disturbances at the immediate and distal sites of spinal cord injury including metabolic enzymatic disturbance, therefore reducing secondary spinal cord degeneration.

The key element in preventing neurovascular deterioration in spinal cord injury is early hyperbaric oxygen therapy implementation. Further hyperbaric oxygen therapy in later rehabilitation will speed up neuromuscular recovery.

Although SCI fits under “investigative condition” category and may not be covered by insurance, many hospitals around the world especially in Asia (ref Asamoto et al. 2000, Lee et al.  1989) are using hyperbaric oxygen as an initial treatment in acute patients and later as addition to rehabilitation in chronic patients.

Early oxygen therapy provides protection against progressive degeneration of post traumatic spinal cord injury.

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Spinal cord injury recovery 
by Ryan C, Vancouver
:

"I’ve already surpassed everyone’s expectations of what my limits are supposed to be, and I look forward to keep proving them wrong!!"

Spinal cord injury
A.R. - Parksville

"A picture tells a thousand words. Thanks!"

Symptoms Rational for HBOT Cost vs benefits
In acute, early SCI neurovascular damage of the spinal cord results in decreased blood flow (ischemia) and reduced oxygen supply (hypoxia) causing swelling and inflammation that further reduce blood supply. This vicious circle causes further progressive neuronal damage. Early oxygen therapy provides protection against progressive degeneration of post traumatic spinal cord injury Shorter hospital stay and faster rehabilitation
Inability to exercise due to excess concentrations of lactate, pyruvate and ammonia cause spasticity andfatigue Improves metabolic circulatory function which reduces muscle spasm and increases muscle strength. Increases capacity for exercise and reduces fatigue Improved neuromuscular function and faster recovery
Headaches Improves CSF (cerebral spinal fluid) dynamics, reduces intracranial pressure (ICP) and neurovascular deterioration. This would reduce migraine and cluster headache attacks and pains Improved quality of life
Immobility can cause pressure sores (decubitus ulcer) – open wound caused by pressure on the skin. Speeds up wound healing by promoting micro circulation and fibroblastic function of collagen synthesis A few sessions of HBO can turn a hypoxic/ischemic non-healing wound into a healing wound. Cost of wound dressing alone can reach $4000-$5000 per year
Inflammation – caused by reduced blood flow, leads to accumulation of toxic substances (ammonia and lactate). Consequent swelling further impairs blood supply causing pain. Improved blood supply reduces inflammation and swelling which cause pain. Improved quality of life
Bacterial infection promotes ischemia and hypoxic development which interferes with local perfusion. Hypoxia limits antibiotics therapeutic function. Prevents and treats infection by: having direct bacteriostatic effect (kills most bacteria), improving function of white blood cells (phagocytosis), improves function of antibiotics. Improved circulation in the wound bed allows for successful skin grafting.
Deep bone infection – osteomyelitis Improves removal of necrotic (dead) bone, facilitates formation of a new bone tissue(osteogenesis) and strengthens the existing bone structure If not responding to antibiotics osteomyelitis can cause death. (Christopher Reeves)
Muscle weakness and pain Relives pain by removing excess of ammonia, lactate and pyruvate. Reduces muscle spasm and increases muscle strength. Increases exercise capacity and range of movement, reduces weakness and fatigue Faster recovery. Effect magnified when combined with physiotherapy and electrical stimulation.
Peripheral nerve damage Facilitates nerve regenerationImproves sensitivity and decreases parasthesia “pins and needles” sensation Faster recovery. Results even better when combined with functional electrical stimulation.
Central nerve damage – loss of control, inability to make a movement Improved brain oxygenation and circulation. Improved permeability of blood brain barrier (BBB). Activation of the unaffected (dormant) neurons in the penumbra zone. Faster recovery due to improved control of movement combined with improved neuromuscular function.
Bowel problems such as constipation, diarrhea and impaction that can lead to perineal fissure, fistulas and other complication. Soiled skin can be source of infection. Regulates motility.Enhances closure of perineal fistulas and fissures. Prevents infections by improving skin microcirculation and strengthening immune system. Reduced/avoided hospital stay.
Bladder dysfunction (incontinence) – susceptibility to infection is due to retention of urine and frequent need for catheterization (causing bacteria that are normally on the skin to be pushed into the bladder) Reduces bladder spasticity (muscle tension). Increases bladder capacity and improves bladder control of emptying. Urinary urgency and frequency is reduced. Prevents infections. Reduced possibility of infections and open wounds (pressure sores).
Respiratory problem – reduced vital capacity, impaired cough reflex (aspiration pneumonia) Increases vital capacity. Prevents respiratory tract infections. Improved quality of life.

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