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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 - |
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 |
After 6 months
After Assessment
of type of
scar (Cystic
\Lacerative or Diffuse ) Duroplasty
Scar
reduction
Implantation of autologous stem
cells
intravenous/intraarterial/intrathecal/epidural/caudal
injection of
autologous stem cells
intraspinal/intralesional
injection of autologous stem cells
Whole
Autologous olfactory tissue transplantation
Omental transposition
+\- |