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 –
*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