Treatment

All patients will undergo active rehabilitation.

All Patients are  followed up at monthly interval . Neurological evaluation will be done at 3 monthly interval by a neurologist and will be graded according  to ASIA protocol.

Electrophysiological evaluation for recovery of MEP or SEP and MRI for changes in anatomy of cord   will be done at 6 months then after at one year. 

After clinical (ASIA) and MRI staging of severity (contusion  & total disruption  with or without gap) we start with –

Immediate 

*Postural reduction 

*Hypothermia –

*maintain Blood Pressure on higher side 

*maintenance of arterial oxygen levels

 

Followed by Decompressive surgery with fixation +\- omental transposition as early as possible.

Omentum transposition in acute setting is  indicated only in pure contusion in injuries 

Omentum transposition should be deferred for at least 2-6 weeks in  patients with laceration /maceration 

There are high chances of  loosing  living  swollen grey matter .

Patients should be serially evaluated and monitored for progression of odema resolution. 

(these observations are derived from a the first ever clinical trial omental transposition with dr Harry Goldsmith (pioneer in omental transposition surgery  in acute sci in supported ISCI Iceland)

  • In subacute phase
  • With in 15 days to 6 months
  • Intraveonous/intrathecal/intrarterial Injection of autologous stem cells.
  • Auyervedic medicines –extract of mimosa pudica
  • Drugs like Minocycline
  • Physiotherapy And specific Rehabilitation Regimen