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Thread: T-6 Incomplete

  1. #1

    T-6 Incomplete

    My name is William. I just joined this forum. I wanted to join so that i can get info and hear others stories. I was in a motorcycle accident May 23rd, 2010. I was coming up on a turn and couldnt see how sharp the turn was. i turned as hard as i could to make the turn, i would of made the turn if it wasnt for gravel in the middle of the road. the gravel made my bike skip which threw me off head first into the gaurdrail. I suffered a t-6 compression fracture. Im in the army and going through a med board process which means ill be getting out soon. Im also married and my wife is in the army too also getting out for me. so far its been 10 months post injury. I can feel my bladder getting full so i know when i have to use a cathater and i know when i have to go number 2. I can feel my legs being moved and know when people grab and mess with my legs and feet. Its like i can feel everything in the inside but cant feel the outside. I have alot of spasms. I recently started bening able to flex my back muscles all the way down to my tail bone. i can also push out my stomach and very little suck it in. I would like to hear from other people how theyre healing is going so that i can stay positive. thank you all for reading and sharing. talk to u soon

  2. #2
    Welcome to our forums! Please also post in our SCI Veterans forum since it appears you are moving from active duty status to Veteran status soon.

    I hope you had a good rehab experience (which VA SCI Center did you attend for this?).

    Please don't hesitate to ask questions and participate in our discussions. There are a lot of good people here.

    (KLD)

  3. #3
    Senior Member JEAPOW's Avatar
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    welcome

    Welcome William, glad you found CC, but sorry you were injured. There are wonderful stories on here. You can also find alot of information here.

    I was just injured in Nov and am still in recovery. My family was told I would never walk again. I am now walking with a walker. So don't ever give up hope. I had L1Burst Frac Inc and am fused between L1-L2. There are days when it can be overwheming, and days of tears and days of joy.


    I wish you the best, for your wife there are many caregivers on here also. Keep up the faith.
    JeAnNE L1Burst Fracture inc. 11/5/10

    Live Well--Laugh often

  4. #4
    Quote Originally Posted by WILLIAM ZAYAS View Post
    My name is William. I just joined this forum. I wanted to join so that i can get info and hear others stories. I was in a motorcycle accident May 23rd, 2010. I was coming up on a turn and couldnt see how sharp the turn was. i turned as hard as i could to make the turn, i would of made the turn if it wasnt for gravel in the middle of the road. the gravel made my bike skip which threw me off head first into the gaurdrail. I suffered a t-6 compression fracture. Im in the army and going through a med board process which means ill be getting out soon. Im also married and my wife is in the army too also getting out for me. so far its been 10 months post injury. I can feel my bladder getting full so i know when i have to use a cathater and i know when i have to go number 2. I can feel my legs being moved and know when people grab and mess with my legs and feet. Its like i can feel everything in the inside but cant feel the outside. I have alot of spasms. I recently started bening able to flex my back muscles all the way down to my tail bone. i can also push out my stomach and very little suck it in. I would like to hear from other people how theyre healing is going so that i can stay positive. thank you all for reading and sharing. talk to u soon
    Always look for improvement and be satisfied at where you are right now but always push yourself to do more. Gains can still come Im 4-5 years out and still feel as if I improve at some level you have to push and be patient at the same time. I wish you the best my friend, you will find this website very informative

  5. #5
    Senior Member diddlindoug's Avatar
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    Welcome William...but wish I did not meet you on this board, but glad you found it! I am fairly new to it, but almost 4 years post injury ( I fell outta 2nd story window headfirst. Lots of info on here...good luck and hope o chat soon!
    dougie

  6. #6
    Welcome

  7. #7
    thank you all for the reply. does anyone know if spasm keep you from actually healing? i know it can help you keep muscle tone but just worried it might keep me from healing.

  8. #8
    Senior Member djrolling's Avatar
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    Quote Originally Posted by WILLIAM ZAYAS View Post
    thank you all for the reply. does anyone know if spasm keep you from actually healing? i know it can help you keep muscle tone but just worried it might keep me from healing.
    I cannot imagine that they would prevent healing... If they are not bad and hence very aggravating or interrupt your life a lot or in a dangerous way then as a whole they are a good thing...IMO

  9. #9
    What you do you mean by "healing"? I assume that you are referring to the spinal cord. Perhaps I should describe what happens to the spinal cord at the time of injury and afterward. Let me first describe the anatomy so that the terms are clear.

    The spinal cord is a relatively soft rope-like extension of the brain. It is covered by three membranes. The pia mater (meaning tender mother) lies on the surface of the spinal cord. The arachnoid (meaning spider-like because it has blood vessels in it) holds the cerebrospinal fluid (CSF) in and is responsible for absorbing the CSF as well. The dura mater (meaning hard mother) is a relatively thick and tough membrane ensheathes the spinal cord. Spinal roots come out of the spinal cord to exit through holes (foramina) in the vertebral column. There is a pair of anterior (motor) and posterior (sensory) roots that come out on each side at each vertebral level.

    The spinal column has 29 vertebral segments (7 cervical, 12 thoracic, 5 lumbar, and 5 sacral). About 5% of the population have 13 thoracic vertebral segments. The spinal cord ends just below the L1 vertebral segments. However, spinal roots continue down the canal to exit from the correct segmental foramina. The end of the spinal cord is called the conus and the rest of the spinal canal is filled with spinal roots and is called cauda equina (meaning horse's tail).

    Because the dura is very tough, it is difficult to cut. So, in almost all cases unless a knife is used or a bullet has penetrated the spinal canal, the dura is usually intact. Occasionally, the dura is torn but even in such cases the spinal cord is seldom, if ever severed or cut so that the two cut ends are separated. In all the years that I have been involved in spinal cord injury research, I have never seen a severed spinal cord. I have heard of bullet in the canal where much of the spinal cord may have been damaged.

    The vast majority of the spinal cord involves compression or contusion of the spinal cord. Compression is when the spinal cord is indented at speeds of less than 0.5 meters per second. When the spinal cord is compressed, it increases the pressure in the spinal cord. When the pressure in the spinal cord exceeds blood pressure, blood flow stops. When the compression is not maintained for longer than 10-20 minutes, the spinal cord becomes damaged for the lack of blood flow (ischemic).

    A compressive injury tends to damage the gray matter (where the neurons are located) and unmyelinated axons (nerve fibers). A more rapid compression that exceeds 0.5 meters per second is called a contusion. In such a case, the spinal cord is rapidly indented to more than half of its diameter by bone or other blunt objects. When this happens, the spinal cord is pushed out of the way and can only move longitudinally along its axis. The reason why the speed is important is because axons break at 0.5 meters per second.

    Axons are in the white matter of the spinal cord. Ascending axons carry sensory information to the brain. Descending axons carry motor information to the lower spinal cord where the motoneurons and interneuronal circuitry are. Some axons are very long. For example, the axons that carry information from your big toe to your brain come from a neuron located in the dorsal root sensory ganglion just outside your spinal cord and this neuron sends one axon to your toe and one axon into the spinal cord where it goes all the way to the brainstem.

    In order to conduct signals rapidly, axons are myelinated. Myelin is sort of like insulation around the axons. Oligodendroglial cells provide myelin, forming a myelin sheath over one segment of the axons. There is a small space called the Node of Ranvier between myelin segments of axons. Electrical signals jump from node to node when action potentials travel up and down the spinal cord.

    Large myelinated axons are most susceptible to breakage when they are stretched at speeds exceeding 0.5 meter per second. When you stretch axons slowly, they will stretch and will not break. However, at speeds exceeding 0.5 meters per second, the axons break at the nodes of Ranvier. In addition, compression or ischemia can damage oligodendroglial cells to cause demyelination of the axons.

    When the axons break, they don't die back right away. It takes a couple of hours for the ends of the axons to die back from the break point. Over several days, the end of the axon that is still connected to the cell body will die back a short distance from the injury site. The part of the axons that has been detached from the axons will shrivel up and eventually degenerate, a process that is called Wallerian degeneration.

    If half of your spinal cord white matter is composed of ascending axons and half are descending axons, a severe injury to the spinal cord that disrupts most of the axons at the injury site will result in loss of at least half of the white matter above and below the injury site. The spinal cord will shrink or undergo atrophy both above and below the injury site for some distance. The spinal cord will be narrowed for at least 2-3 segments around the injury site.

    At about 24 hours after the injury, macrophages (these are scavenger cells) come into the injury site and start cleaning up all the dead and moribund cells. After a period, stem cells move into the injury site and convert the macrophage into angiongenic (or blood vessel building) cells. Astrocytes (glial cells) around the injury site will start dividing and making more astrocytes because they must line the blood vessels (capillaries) with their "end-feet", which eventually fuse together to form the blood brain barrier.

    During the first 8 hours after injury, a strong inflammatory responses occurs at the injury site and this response may damage more axon than the original physical injury (primary injury) did. This is called secondary injury and may involve inflammation as well as free radicals that are released at the injury site. In any case, we had found in 1990 that if a very high dose of methylprednisolone is given to the spinal cord, it dampens the inflammatory response and can save some axons and improve both motore and sensory recovery by about 20%.

    Over a period of weeks, the spinal cord gradually "heals". What remains is repaired. What cannot be repaired is simply walled off (into a cyst). Demyelinated axons may be remyelinated. Regrowing axons may be myelinated. Note that the spinal cord has stem cells and also stem cells from the peripheral blood and bone marrow are present at the injury site as well. Usually, all the "healing" occurs during the first few weeks after spinal cord injury.

    In some people, sensory axons that have been disconnected may sprout and connect with nearby neurons. Likewise, motor axons from above the injury site may sprout and connect with neurons that they normally would not. Also, many of the descending axons from the brain to the spinal cord are inhibitory. So, spinal cord increases the excitability of the lower spinal cord. Sprouting may also increase that excitability. This manifests in spasticity and spasms.

    Spasticity is increased reflexes and tone of the muscles. Spasms are spontaneous and non-voluntary movements of the muscle. If you have spasticity or spasms, it means that the neurons in your lower spinal cord are alive and kicking. I have often said that spasticity and spasms are nature's own exercise machines. They will keep up the muscle in your legs. If the spasticity is too much, baclofen (up to 80 mg per day) may help. If spasms are too much, gabapentin (up to 1-2 grams per day) may be useful.

    Neuropathic pain is sort of the other side of the coin to spasticity and spasms. Rather than motor activity, neuropathic is abnormal sensory activity. Some people have pain and others do not. We recently found that rats who were given methylprednisolone early have less neuropathic pain than rats that were not treated. About 50% of people have significant neuropathic pain, usually in the parts of the body where they cannot feel. For the slow constant burning or pressure pain, sometimes amitryptyline (20-40 mg per day) may help. For sharp and intermittent pains, gabapentin (neurontin) may help but usually one has to push gabapentin doses to very high levels before it works.

    Over time, I believe that some regeneration may occur in the spinal cord. It is usually limited, particularly in people with severe injuries. I think that people who have incomplete injuries often recover because of regeneration. Regeneration will take a long time to restore function. Axons grow no faster than your hair. Therefore, to grow from above the injury site to the bottom of the spinal cord may take many months or even years.

    Most people get 80% of their recovery during the first 12 months after injury. However, some people continue to recover function for 4-5 years after injury or even longer. There is a theory called "learned non-use" that is sweeping rehabilitation circles. This theory says that if you don't use your neural circuitry for several weeks, the neural circuits will undergo atrophy just like muscle would. In order to rebuild the muscles, it is important move them. Likewise, after regenerative therapies, one needs to impose exercises that activate the activity that we would like to see them doing and avoid those that activate systems that we would likely to see grow further.

    Please note that many studies suggest that over 90% of people with "incomplete" spinal cord injury are able tor recover walking if they engage in intensive overground locomotor training. While treadmill walking may help establish the stepping movement, it is important that the training be done with overground wheeled support platforms.

    Wise.

  10. #10
    wow thanks wise young this was very informative. Ive heard alot of doctors use the term scar tissue that developes on the spinal cord, Ive read that the term SCAR TISSUE is incorrect, it said that its not really scar tissue that developes. What is it?

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