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View Full Version : Injury to spine causing temporary paralysis?



BellaRush
01-11-2009, 07:15 AM
Is this a credible situation? I admit that I got the idea from a novel I read as a kid, where a girl was kicked in the back by a horse, and suffered temporary paralysis that was resolved with surgery (had something to do with pressure on nerves). My scenario is a jockey who has a spill in a race, and I need something that will really shake him up, but that he can recover from and be back on a horse in about three months. Possible?

What about immediate treatment for a potential spinal injury on arrival at the hospital?

Mythical Tiger
01-11-2009, 07:42 AM
That might work. It really depends on how serious he gets hurt. I myself have been trampled when I was 9. Luckily I had nothing but terrible bruising on my back. *shivers* I could have been killed.

Did he break anything? Or just fracture it?

thethinker42
01-11-2009, 07:46 AM
I could be very, very wrong, but I seem to recall hearing about someone who had been injured (also in a horseback riding accident; we were all sharing war stories about our horse show days) and had some temporary paralysis due to swelling that compressed some nerves. When the swelling went down, the mobility/sensation came back.

I don't know all the specifics, I just remember that coming into the conversation.

Horseshoes
01-11-2009, 07:56 AM
Very believable--I've witnessed several of these scenarios (from falls and car wrecks but a horse splat, eminently believable).

As The Thinker said--swelling si the way to go. SWelling from an injury, rather like your last sprained ankle, goes down, voila, no more pressure. The cord is in a strict housing and cannot tolerate swelling.

Re treatment (tx usu abbrev), what's eye-catching is this is the situation where the transporting paramedics usu lose their (wood or plastic) backboards. The ER will not take the pt off--rads (sorry, x-rays) first. And this really is the ER's first tx, provided there're no other complication. Fall from horse, can't move, no other complaints? send that boy (who's staying strapped to a backboard-cath'd if he has any urge to pee) to Radiology. Then we'll talk.

BellaRush
01-11-2009, 08:52 AM
Great, thanks so much, everyone. So assuming radiographs show no fracture, would the assumption be made that it would be swelling/compression or would further diagnostics be used to confirm that? Steroids to help reduce the inflammation? I'd really like to throw some surgery at him if that could be worked in. :D

Mumbleduck
01-12-2009, 04:28 AM
A friend of my husband's was in a car wreck last summer, and she was paralyzed due to a crushing injury in her neck - she had to have surgery to fuse the vertebrae, because, at least this is how I understood it at the time, they were so weak that she was at risk of her neck snapping (which obviously, would kill her) - that might be something to consider for your character, though it would probably require a more severe injury than what you're thinking of, as my friend's was caused by actual damage to the nerves in the accident, rather than swelling from other, less severe injuries.

Rabe
01-12-2009, 01:04 PM
My father worked as a butcher for most of his life. At one point he was pulling out cases of meat to be cut when someone else came along and tried to help him. He wound up falling over a loading cart while holding a case of meat.

He told everyone to leave him alone and not to call an ambulance, he was fine and wanted to get back to work. Except he couldn't get up. He was fully paralyzed in one leg and mostly paralyzed in the other. He was flown to another town with a more advanced trauma care unit because they didn't know if the paralysis was permanent or due to swelling.

Fortunately for him, it was due to swelling and sensation/use of his legs came back within three days as they treated the swelling.

He fell over backward and the case of meat landed on his midsection, all of which strained his back to the point of swelling - which caused compression on the nerves. This resulted in less signals getting through.

So it's possible and - judging from the thread - in more ways than one.

Rabe...

bonobo_jones
01-12-2009, 01:58 PM
Friend of mine had a nasty fall on ice a few years ago and wrenched her back. I took her to the ER because she lost all feeling in one of her legs and couldn't walk, let alone drive. Among other things they gave her a steroid shot directly into the spine, which reduced the swelling and relieved the pain and numbness very quickly. I think she also had an MRI on admission. It was all outpatient, we were just there a few hours.

ColoradoGuy
01-12-2009, 05:59 PM
Acute spinal cord compromise from swelling after an injury as you describe is a well known thing. It is diagnosed (after the physical exam showing the paralysis) by MRI scan. It is usually treated with high-dose steroids, although lately the usefulness of this therapy has been questioned.

Tsu Dho Nimh
01-12-2009, 10:27 PM
had some temporary paralysis due to swelling that compressed some nerves. When the swelling went down, the mobility/sensation came back.

This is well-known ... think of a "funny bone", or when you sleep in an awkward position and your leg doesn't work for a few moments.

Bruises and broken bones can cause a temporary paralysis. The danger is that the pressure can permanently damage the nerve if it lasts too long.

BellaRush
01-13-2009, 07:20 PM
Thanks everybody!



Bruises and broken bones can cause a temporary paralysis. The danger is that the pressure can permanently damage the nerve if it lasts too long.

So I'm still looking at the surgery thing.;) Wondering if it would be a course of action if this was a concern. I expect initially they would wait to see if the paralysis reversed as the inflammation decreased, but if this wasn't happening in a reasonable time frame (whatever that would be!) would they go in...especially as, being a typical athlete, the character would push for whatever is going to resolve things the fastest, despite potential risks. Obviously he's still going to have to deal with some rehab...

A friend of mine broke her back and had it fused as well - I think that would mess up my timeframe though! It would probably require a bit more rehab time than 3 months.

ColoradoGuy
01-14-2009, 03:36 AM
Thanks everybody!



So I'm still looking at the surgery thing.;) Wondering if it would be a course of action if this was a concern. I expect initially they would wait to see if the paralysis reversed as the inflammation decreased, but if this wasn't happening in a reasonable time frame (whatever that would be!) would they go in...especially as, being a typical athlete, the character would push for whatever is going to resolve things the fastest, despite potential risks. Obviously he's still going to have to deal with some rehab...

A friend of mine broke her back and had it fused as well - I think that would mess up my timeframe though! It would probably require a bit more rehab time than 3 months.

It would depend upon what the MRI showed. If the spinal cord was diffusely swollen, there's nothing to do surgery on. But if there's something pushing on the cord, such as a blood clot, then surgery could be an option.

Hummingbird
01-14-2009, 09:54 AM
Perhaps your character could land wrong when falling off the horse and get a Herniated Disc? 1 in 10 people have to have surgery to fix it.

My mother has a herniated disc and when it is flared up and swollen it presses on a nerve in her back and she can't feel her legs. She was even prescribed an electric wheelchair one time it got really bad. My mother got it from normal wear and tear on the spine and finally a kick in the back from a goat. The hoof hit her just right to permenently mess one of her discs up.

Edit: Here's a website on it. :) http://www.webmd.com/back-pain/tc/herniated-disc-topic-overview