Many spinal cord injuries in UAE not due to accidents, say doctors

A significant number of spinal cord injuries in the UAE are not due to traumatic causes, such as car accidents, according to experts. Every year, somewhere between 250,000 and 500,000 people suffer an injury to their spinal cord, according to the World Health Organisation. Globally, most of those cases, up to 90 per cent, result from traumatic causes, said the global health body. “The most common causes of traumatic spinal cord injuries would be road traffic accidents, falls, injuries due to violence or sports,” said Dr Khalid Anwar, consultant of physical medicine and rehabilitation at Amana Healthcare, who was speaking ahead of World Spinal Injury Day on September 5. “These are the main reasons for the traumatic injuries. “But I think many people would be surprised to know there are many causes of non-traumatic spinal cord injuries. “And in fact the incidence of non-traumatic spinal cord injuries [in the UAE] is greater than traumatic spinal cord injuries.” Non-traumatic spinal cord injuries result from numerous causes, he said. Some patients receive injuries to their spinal cord due to compression, which could include narrowing of the cord. “Some patients would have a tumour in the spinal cord, which could be a primary tumour or metasteses from a tumour in any other part of the body. “Another reason could be because of inflammatory causes or autoimmune causes. For example, we know that patients with MS can, because of the inflammatory process, sustain damage to the spinal cord, which results in weakness of their limbs.” Other causes include damage from radiation, infection or a disruption of blood to the spinal cord, in a process that is similar to a stroke in the brain, known as an infarction. He said one recent patient, an 18-year-old Emirati woman who was referred to Amana late last year, suffered a spinal cord injury this way, due to infarction, which caused a blockage in blood supply to the spinal cord. The cause of the blood clot was never discovered. But she has been able to make a good recovery, despite suffering a severe injury as a result. “In some patients, in spite of a lot of investigation, we are unable to find what caused it. Unfortunately she was in that group of patients. “Normally you would expect such kind of thing to happen in elderly patients whose vascular system was not good. But in an 18-year-old, it is very expected. Unfortunately, that is what she had,” said Dr Anwar. The resulting damage left her with weakness in all four limbs and difficulties breathing. When she arrived at Amana she was on a ventilator. She was gradually weaned off it and embarked on intensive therapy, which included strengthening exercises and occupational therapy that helped her relearn how to do things for herself again. She was discharged from inpatient care in March, walking with a stick. She has since resumed her studies in microbiology. “She is very lucky in that despite what looked like a very severe injury to her spinal cord, she has done extremely well. I know she is still needing help with bowel and bladder management. “But apart from that she is mobilising, she is socialising. She goes out, she has gone back to her educational activities and all that.” She is one of the lucky ones. A significant number of patients with spinal cord injuries do not recover as well as she has. The spinal cord can either suffer a complete or incomplete injury, said Dr Anwar. “Of patients who have complete injuries, so complete disruption of all the nerves, the chances of them recovering fully is very little. Although with rehab, they do regain independence depending on where the level of injury was. “But the patients with incomplete injuries have a good chance of improvement, which can take from a few months to a few years. It’s not something that happens very quickly. “The chances of recovery all depends how severe the initial spinal injury to the cord is. That is very important.”

Many spinal cord injuries in UAE not due to accidents, say doctors

Non-traumatic causes include spinal compression, infection and inflammation