Archive for the ‘Spinal Cord Injury’ Category
Spinal Cord Injury Network – Spinal Cord Injury Network is one of the most comprehensive spinal cord injury website resources around. Find out everything you need to know about spinal cord injuries and paralysis all in one easy to access site. Listed below is a quick guide to spinal cord injury, everything is explained in much more detail inside the spinal cord injury network site
Spinal Cord Injury Spinal cord injury effects vary according to the type and level of spinal cord injury, and can be sorted into two main types:
In a complete spinal cord injury, there is no function below the “neurological” level, defined as the lowest level that has intact neurological function. If a person has some spinal injury level below which there is no motor and sensory function, the injury is said to be a complete spinal cord injury.
An incomplete spinal cord injury will retain some sensation or movement below the level of spinal cord injury. Incomplete spinal cord injuries may recover some walking ability. In addition to a loss of sensation and motor function below the point of spinal cord injury, individuals with spinal cord injuries will often experience other complications of spinal cord injury
A few Spinal Cord injury facts Spinal cord injury is relatively rare and estimated to affect between 35 to 65 people in every million population every year, Spinal cord injury is most prevalent in younger males aged 15 -35 The average age for spinal cord injury is 31 Spinal cord injury is most commonly caused by vehicle and sporting accidents You can have a spine injury including fractured or broken vertebrae without suffering a spinal cord injury. whiplash and falls can cause immediate symptoms of spinal cord injury which then diminish, whilst in these cases it is may be unlikely that any permanent spinal cord injury has happened its essential to seek medical advice Every year, about 2000 people in the UK suffer traumatic spinal cord injury leading to permanent paralysis. A cure for Spinal Cord Injury? It has been said since the end of the last century that spinal cord injury will eventually be repairable and that research looking at ways to restore function lost by spinal cord injury is showing promising signs, however to date there is no cure for spinal cord injury. When a spinal cord injury occurs The initial trauma can include both traction, which pulls nerve cells apart, and compression, which damages nerves and blood vessels. Nerve fibres that are detached from their cell nucleus must be rejoined within 4872 hours or function is lost forever
Compensation for Spinal Cord Injury?
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Spinal Cord Injury – Spinal Cord Injury
Think you know the facts about spinal cord injuries? Here is some information that may surprise you.
According to the National Spinal Cord Injury Statistical Center at UAB, the distribution of the causes of SCI have changed drastically since 2010.
Researchers have estimated that, as of 2015, 12500 new SCI occur each year and between 240,000 and 337,000 people are currently living with SCI in the United States.
The average age at injury has moved from 29 years in the 1970’s to 42 years in 2015.
The length of hospital stays is declining with the average stay in hospital acute care at 11 days – down from 24 in the 1970’s – and rehabilitations stays at 36 days – down from 98 days in the 1970’s.
Statistics and information provided by Panish Shea & Boyle.
Source: The University of Alabama National Spinal Cord Injury Statistical Center – March 2002
Although there is more information available about people who have a spinal cord injury than ever before, much of it is incomplete. Some of the statistical data is summarized below per 8/95.
32 injuries per million population or 7800 injuries in the US each year
Most researchers feel that these numbers represent significant under- reporting. Injuries not recorded include cases where the patient instantaneously or soon after the injury, cases with little or no remaining neurological deficit, and people who have neurologic problems secondary to trauma, but are not classified as SCI. Researchers estimate that an additional 20 cases per million (4860 per year) die before reaching the hospital.
People who return to work in the first year post-injury usually return to the same job for the same employer. People who return to work after the first year post-injury either worked for different employers or were students who found work.
Until the most recent figures were released by NSCIA in August,1995, these were considered as the major causes of spinal cord injuries. See Answer to # 4 and Dr. Wise Youngs statistics in Section 2 for allthe most recent demographics. One of the most surprising findings isthat acts of violence have now overtaken falls as the second mostcommon source of spinal cord injury, as of the 1995 findings.
Since 1988, 45% of all injuries have been complete, 55% incomplete. Complete injuries result in total loss of sensation and function below the injury level. Incomplete injuries result in partial loss. “Complete” does not necessarily mean the cord has been severed. Each of the above categories can occur in paraplegia and quadriplegia.
Except for the incomplete-Preserved motor (functional), no more than 0.9% fully recover, although all can improve from the initial diagnosis.
Overall, slightly more than 1/2 of all injuries result in quadriplegia. However, the proportion of quadriplegics increase markedly after age 45, comprising 2/3 of all injuries after age 60 and 87% of all injuries after age 75. 92% of all sports injuries result in quadriplegia.
Most people with neurologically complete lesions above C-3 die before receiving medical treatment. Those who survive are usually dependent on mechanical respirators to breathe.
50% of all cases have other injuries associated with the spinal cord injury.
Quadriplegia, incomplete 31.2% Paraplegia, complete 28.2% Paraplegia, incomplete 23.1% Quadriplegia, complete 17.5%
(Important: This section applies only to individuals who were admitted to one of the hospitals designated as “Model” SCI centers by the National Institute of Disability and Rehabilitation Research.)
Over 37% of all cases admitted to the Spinal Cord Injury System sponsored by the NIDRR arrive within 24 hours of injury. The mean time between injury and admission is 6 days.
Only 10-15% of all people with injuries are admitted to the NIDRR SCI system. The remainder go to CARF facilities or to general hospitals in their local community.
It is now known that the length of stay and hospital charges for acute care and initial rehabilitation are higher for cases where admission to the SCI system is delayed beyond 24 hours. Average length of stay (1992):
Quadriplegics 95 days Paraplegics 67 days All 79 days
Average charges (1990 dollars) Note: Specific cases are considerably higher.
Quadriplegics $118,900 Paraplegics $ 85,100 All $ 99,553
Source of payment acute care:
Private Insurance 53% Medicaid 25% Self-pay 1% Vocational Rehab 14% Worker’s Comp 12% Medicare 5% Other 2%
Ongoing medical care: (Many people have more than one source of payment.)
Private Insurance 43% Medicare 25% Self-pay 2% Medicaid 31% Worker’s Compensation 11% Vocational Rehab 16%
Residence at discharge
Private Residence 92% Nursing Home 4% Other Hospital 2% Group Home 2%
There is no apparent relationship between severity of injury and nursing home admission, indicating that admission is caused by other factors (i.e. family can’t take care of person, medical complications, etc.) Nursing home admission is more common among elderly persons.
Each year 1/3 to 1/2 of all people with SCI are re-admitted to the hospital. There is no difference in the rate of re-admissions between persons with paraplegia and quadriplegia, but there is a difference between the rate for those with complete and incomplete injuries.
Overall, 85% of SCI patients who survive the first 24 hours are still alive 10 years later, compared with 98% of the non-SCI population given similar age and sex.
The most common cause of death is respiratory ailment, whereas, in the past it was renal failure. An increasing number of people with SCI are dying of unrelated causes such as cancer or cardiovascular disease, similar to that of the general population. Mortality rates are significantly higher during the first year after injury than during subsequent years.
Spinal Cord Injury
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The spinal cord is a bundle of nerves that carries messages between the brain and the rest of the body.
Acute spinal cord injury (SCI) is due to a traumatic injury that can either result in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord. About 250,000 to 400,000 individuals in the US have a spinal cord injury. About 60 percent of these cases are 30 years old or younger.
The annual incidence of spinal cord injury in the U.S. is 40 cases per million, or 12,000 new cases each year. The number of people in the U.S. in 2008 living with a spinal cord injury is approximately 259,000, with a range of 229,000 to 306,000.
SCI results in a decreased or absence of movement, sensation, and body organ function below the level of the injury. The most common sites of injury are the cervical and thoracic areas. SCI is a common cause of permanent disability and death in children and adults.
The spine consists of 33 vertebrae, including the following:
* By adulthood, the 5 sacral vertebrae fuse to form one bone, and the 4 coccygeal vertebrae fuse to form one bone.)
These vertebrae function to stabilize the spine and protect the spinal cord. In general, the higher in the spinal column the injury occurs, the more dysfunction a person will have.
Injury to the vertebrae does not always mean the spinal cord has been damaged. Likewise, damage to the spinal cord itself can occur without fractures or dislocations of the vertebrae.
There are many causes of SCI. The more common injuries occur when the area of the spine or neck is bent or compressed, as in the following:
Penetrating injuries that pierce the cord, such as gunshots and stab wounds may also cause damage.
Symptoms vary depending on the severity and location of the SCI. At first, the patient may experience spinal shock, which causes loss of feeling, muscle movement, and reflexes below the level of injury. Spinal shock usually lasts from several hours to several weeks. As the period of shock subsides, other symptoms appear, depending on the location of the injury.
Generally, the higher up the level of the injury to the spinal cord, the more severe the symptoms. For example, an injury at C2 or C3 (the second and third vertebrae in the spinal column), affects the respiratory muscles and the ability to breathe. A lower injury, in the lumbar vertebrae, may affect nerve and muscle control to the bladder, bowel, and legs.
The following are the most common symptoms of acute spinal cord injuries. However, each individual may experience symptoms differently.
Symptoms may include:
The symptoms of SCI may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
The following chart is a comparison of the specific level of SCI and the resulting rehabilitation potential. This chart is a guide, with general information only; impairments and rehabilitation potential can vary depending on the type and severity of SCI. Always consult your physician for more specific information based on your individual medical condition and injury.
Rehabilitation of the patient with a SCI begins during the acute treatment phase. As the patient’s condition improves, a more extensive rehabilitation program is often begun.
The success of rehabilitation depends on many variables, including the following:
It is important to focus on maximizing the patient’s capabilities at home and in the community. Positive reinforcement helps recovery by improving self-esteem and promoting independence.
The goal of SCI rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life – physically, emotionally, and socially.
Areas covered in spinal cord injury rehabilitation programs may include:
The spinal cord injury rehabilitation team revolves around the patient and family and helps set short-and long-term treatment goals for recovery. Many skilled professionals are part of the spinal cord injury rehabilitation team, including any/all of the following:
There are a variety of spinal cord injury treatment programs, including the following:
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Spinal Cord Injury – Conditions – For Patients …
Read advice from Dr. Jeffrey Rabin, a pediatric rehabilitation specialist at the Childrens National Medical Center. Check out an article on wheelchairs just for teens.
Your spinal cord is a big bundle of nerves that runs down the middle of your back. It carries signals from your brain to the rest of your body and from your body to your brain.
A spinal cord can be injured in several different ways, including from a fall or while playing sports. The most common causes are car accidents. And alcohol often plays a part in spinal cord injuries.
A person who has a spinal cord injury loses all or some feeling and movement below the site of the injury. For example, if your spinal cord is injured just above your hips, you might lose feeling and movement in your hips, legs, and feet.
If you have a spinal injury you may need surgery, physical therapy, and other forms of treatment. You likely will work with a treatment team that includes rehabilitation specialists (see the box below for more information) who will help you build your strength and learn some new ways to do things. They also can help you learn how to take good care of your body. If youll be using a wheelchair, for example, you may learn how to avoid skin sores that can come from sitting for a long time.
Of course, if you have a spinal cord injury, its not just your body thats affected. Your emotions have taken a big hit too. Peoples reactions range from relief that their accident wasnt worse to fear about how their lives may change. Whatever your reactions, your treatment team can help you deal with all that too. Tell them, your parents, or other people you trust how you feel and what they can do to help.
Adjustment is a big part of dealing with a spinal cord injury. Adjustment means getting used to something new and also making changes to better handle something new. Each person who is injured adjusts in his or her own way. For example, some people may not realize how serious their injury is right away. For teens, coping with changes after an injury can be even harder. This is because, as a teen, you also are coping with the change from childhood to adulthood.
Keep in mind that anger and grief are normal. But do not let your feelings keep you from taking care of yourself. Make sure to do what the doctor tells you to do and try to focus on your therapy.
Adjusting to your injury likely will be easier if you:
You will have to adjust to new experiences throughout your life with this injury. As tough as it can be, dealing with the different challenges that come your way will make you strong and will really make you shine! Had you hoped to be a doctor someday before your injury? Or hoped to have a family? Well, your long-term goals may not have to change! Talk to your parents or guardians, health care team, and teachers about what you need to feel more comfortable at school so that you can do well. And, most importantly, follow the advice of your health care team about taking care of your health on a daily basis.
What are pediatric rehabilitation specialists?
They are professionals who help young people get better after a serious illness or injury. They include physical therapists and others who can help you build your skills and strength.
Dr. Jeffrey Rabin, a pediatric rehabilitation specialist at the Childrens National Medical Center, offers this advice on living with spinal cord injury:
Q. What can teens do to feel more comfortable in a hospital or rehabilitation center? A. Teens should know that a hospital is not a pleasant place, and that recovery is going to be hard work. It can help to trust your health care team members they always have your best interests in mind. And, they will do what they can to make your stay as nice as possible.
Q. How can teens make the recovery process smoother? A. Healing after a spinal cord injury is hard on your body and mind. There is also a lot to learn about the other health issues that can go along with spinal cord injuries, but it will get easier to manage these in time. Listen to your doctor and other health care team members when they teach you how to care for yourself.
Q. What should patients ask their doctors? A. Ask your doctor about doing the things you enjoy. He or she wants to hear you ask if you can still go camping and play sports!
Q. What can make it easier for teens with spinal cord injuries to deal with friends and family? A. Let people know that you are still the same person, only now you are dealing with a medical problem. You can tell them that everyone has a medical problem at some point in their lives and that you are dealing with yours early in life.
Q. What should teens know about spinal cord injury research that is going on? A. It is important to be aware of how serious your injury is. At the same time, there is a lot of spinal cord injury research taking place and it is okay to hope for a cure for paralysis someday. The best thing you can do is focus on moving ahead and living life with the injury you have, in the healthiest way possible.
Q. Can teen girls with spinal cord injuries have babies? A. Girls can absolutely become mothers someday! The doors are still wide open for your future goals whether those goals are to have a family or do anything else that you put your mind to.
Content last reviewed February 16,2011 Page last updated October 31,2013
Spinal cord injury | girlshealth.gov
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Quadriplegia, incomplete 31.2% – Paraplegia, complete 28.2% – Paraplegia, incomplete 23.1% – Quadriplegia, complete 17.5%
The figures above represent the resultant permanent disability suffered by a survey of people breaking their backs and necks. These statistics show that an incomplete spinal cord injury is more prevalent than complete ones. The figures for incomplete spinal cord injury may indeed be much higher because they don’t take account of those people who have been treated by general hospitals instead of a specialist spinal injuries unit. Today advances in medical knowledge and patient management at the scene of an injury mean a lot more people will survive what used to be a fatal injury. These advances, critically in patient management are leading to a greater prevalence of incomplete injuries too.
An incomplete spinal cord injury is the term used to describe damage to the spinal cord that is not absolute. The incomplete injury will vary enormously from person to person and will be entirely dependant on the way the spinal cord has been compromised.
The true extent of many incomplete injuries isn’t fully known until 6-8 weeks post injury. The spinal cord normally goes into what is called spinal shock after it has been damaged. The swelling and fluid masses showing on any resultant X-ray, MRI or CT scans, may well mask the true nature of the underlying injury. It is not uncommon for someone who is completely paralysed at the time of injury to get a partial or very near full recovery from their injuries after spinal shock has subsided.
Incomplete Paraplegia – Incomplete Tetraplegia
Types of Incomplete Spinal Injury An incomplete lesion is the term used to describe partial damage to the spinal cord. With an incomplete lesion, some motor and sensory function remains. People with an incomplete injury may have feeling, but little or no movement. Others may have movement and little or no feeling. Incomplete spinal injuries differ from one person to another because the amount of damage to each persons nerve fibres is different.
The effects of incomplete lesions depend upon the area of the cord (front, back, side, etc) affected. The part of the cord damaged depends on the forces involved in the injury.
Anterior Cord Syndrome: is when the damage is towards the front of the spinal cord, this can leave a person with the loss or impaired ability to sense pain, temperature and touch sensations below their level of injury. Pressure and joint sensation may be preserved. It is possible for some people with this injury to later recover some movement. This is a type of incomplete spinal cord injury
Central Cord Syndrome: is when the damage is in the centre of the spinal cord. This typically results in the loss of function in the arms, but some leg movement may be preserved. There may also be some control over the bowel and bladder preserved. It is possible for some recovery from this type of injury, usually starting in the legs, gradually progressing upwards. This is a type of incomplete spinal cord injury
Posterior Cord Syndrome: is when the damage is towards the back of the spinal cord. This type of injury may leave the person with good muscle power, pain and temperature sensation, however they may experience difficulty in coordinating movement of their limbs. This is a type of incomplete spinal cord injury
Brown-Squard syndrome: is when damage is towards one side of the spinal cord. This results in impaired or loss of movement to the injured side, but pain and temperature sensation may be preserved. The opposite side of injury will have normal movement, but pain and temperature sensation will be impaired or lost. This is a type of incomplete spinal cord injury
Cauda equina lesion: The Cauda Equina is the mass of nerves which fan out of the spinal cord at between the first and second Lumbar region of the spine. The spinal cord ends at L1 and L2 at which point a bundle of nerves travel downwards through the Lumbar and Sacral vertebrae. Injury to these nerves will cause partial or complete loss of movement and sensation. It is possible, if the nerves are not too badly damaged, for them to grow again and for the recovery of function. This is a type of incomplete spinal cord injury
Incomplete Paraplegia – Incomplete Tetraplegia – Treatment – Complications – Causes of SCI – My Injury
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Incomplete Spinal Cord Injury
Founded in 2005, the International Center for Spinal Cord Injury (ICSCI) represents something remarkable in the field of paralysis treatment: hope.
For many years, experts held that most improvements from spinal cord injuries (SCI) occurred in the first six months of recovery, and that improvement was impossible after two years. Rehabilitation focused mostly on teaching patients how to compensate for injuries they thought to be irreversible. The experts were wrong.
The International Center for Spinal Cord Injury (ICSCI) at Kennedy Krieger Institute was founded on the philosophy that individuals with paralysis can always hope for recovery of sensation, function, mobility, and independence, months and even years after injury. To maximize on this potential for recovery, ICSCI offers an intense, medically-supervised therapy program with a unique focus on Activity-Based Restorative Therapy.ICSCI is one of the first facilities in the world to combine innovative research with a unique focus on restoration and rehabilitation for both children and adults with chronic paralysis.
Transitioning today’s science to near-term therapeutic applications, we focus on developing and applying advanced restoration strategies for optimizing spontaneous recovery in those living with paralysis.
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International Center for Spinal Cord Injury | Kennedy …
Effects from Spinal Cord Injury The physical and emotional consequences from a spinal cord injury (SCI) can be devastating. Loss of spinal cord function can affect activities that are autonomous (e.g. breathing) as well as thought-driven actions (e.g. driving). Both motor and sensory functions may be lost.
According to the National Spinal Cord Injury Association (NSCIA), not every spinal cord injury results from a motor vehicle accident (42%), violence (24%), falling (22%), or sports (8%). Occasionally SCIs are caused by diseases such as polio. Spinal cord injuries are usually described using the following terms:
Paraparesis: A slight degree of paralysis affecting the lower extremities
Paraplegia: Complete paralysis of both lower extremities and usually the lower trunk. The upper extremities are not involved.
Quadriparesis: Partial paralysis of all four limbs (arms, legs)
Quadriplegia (or Tetraplegia: Complete paralysis of all four limbs
Other terms used to describe neural dysfunction include:
Paresis: Partial paralysis
Paralysis: Partial or complete loss of motor function
Paresthesias: Abnormal sensation such as burning or tingling
The spinal cord does not have to be severed for function to be lost. Most people with spinal cord dysfunction present with the cord intact. Cord injuries usually fall into one of the following categories:
Contusions, or bruising of the spinal cord
Compression injuries that place pressure on the cord
Lacerations or tearing (e.g., from a bullet)
Central Cord Syndrome
Complete severing (rare) W
When injury occurs and for a time period following, the spinal cord swells. Loss of function occurs below the level of the injury and may be permanent or temporary. Much depends on the severity of the injury.
Symptoms may include loss of motor function, sensation or proprioception. The nerves responsible for these functions transmit their messages through the muscles, tendons, joints and other organs.
Destruction of sensory nerve fibers may lead to loss of sensation such as touch, pressure, and temperature. Reflexes may become exaggerated, bladder and bowel control may be lost, even the ability to breath normally may be compromised.
Diagnosis When spinal cord injury is suspected (e.g., spinal fracture) immediate medical attention is required. Spinal cord injury (SCI) is usually first diagnosed when the patient presents with a loss of function below the level of injury.
The initial evaluation includes x-rays, a CT scan, and possibly a MRI. Fractures are demonstrated on plain radiographs. CT scanning and MRI studies are used to evaluate the soft tissues in the spinal column. In addition, a myelogram may be performed to identify and evaluate spinal cord lesions caused by trauma or disease.
The neurologic evaluation includes assessment of the patient’s symptoms, which might include loss of motor or sensory function. Other neurologic symptoms may include pain, numbness, paresthesias (e.g., tingling), muscle spasm, weakness, and bowel/bladder changes.
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Spinal Cord Injury (SCI): Aftermath and Diagnosis
Shepherd Center knows that you and your loved ones have many questions about spinal cord injury. Here are answers to help you learn more:
Every year, about 12,000 people sustain a spinal cord injury. That’s 30 new injuries every day. Most of these people are injured in auto and sports-related accidents, falls and industrial mishaps. An estimated 60 percent of these individuals are 30 years old or younger, and the majority of them are men.
In addition to pressure sores, secondary conditions from spinal cord injuryinclude respiratory complications, urinary tract infections, spasticity and scoliosis.
A spinal cord injury (SCI) is damage to the spinal cord that results in a loss of function, such as mobility and/or feeling. Frequent causes of damage are trauma (car accident, gunshot, falls, etc.) or disease (polio, spina bifida, Friedreichs ataxia, etc.).
The spinal cord does not have to be severed for a loss of function to occur. In fact, in most people with spinal cord injury, the cord is intact, but the damage to it results in loss of function. Spinal cord injury is very different from back injuries, such as ruptured disks, spinal stenosis or pinched nerves.
A person can “break their back or neck” yet not sustain a spinal cord injury if only the bones around the spinal cord (the vertebrae) are damaged, but the spinal cord is not affected. In these situations, the individual may not experience paralysis after the bones are stabilized.
The spinal cord is about 18 inches long and extends from the base of the brain, down the middle of the back, to about the waist. The nerves that lie within the spinal cord are upper motor neurons (UMNs), and their function is to carry the messages back and forth from the brain to the spinal nerves along the spinal tract. The spinal nerves that branch out from the spinal cord to the other parts of the body are called lower motor neurons (LMNs).
These spinal nerves exit and enter at each vertebral level and communicate with specific areas of the body. The sensory portions of the LMN carry messages about sensation from the skin and other body parts and organs to the brain. The motor portions of the LMN send messages from the brain to the various body parts to initiate actions such as muscle movement.
The spinal cord is the major bundle of nerves that carry nerve impulses to and from the brain to the rest of the body. The brain and the spinal cord constitute the central nervous system. Motor and sensory nerves outside the central nervous system constitute the peripheral nervous system. Another diffuse system of nerves that controls involuntary functions, such as blood pressure and temperature regulation, are called the sympathetic and parasympathetic nervous systems.
The spinal cord is surrounded by rings of bone called vertebra. These bones constitute the spinal column (back bones). In general, the higher in the spinal column the injury occurs, the more dysfunction a person will experience. The vertebra are named according to their location. The eight vertebra in the neck are called the cervical vertebra. The top vertebra is called C-1, the next is C-2, etc. Cervical spinal cord injuries usually cause loss of function in the arms and legs, resulting in quadriplegia. The 12 vertebra in the chest are called the thoracic vertebra. The first thoracic vertebra, T-1, is the vertebra where the top rib attaches.
Injuries in the thoracic region usually affect the chest and the legs, resulting in paraplegia. The vertebra in the lower back between the thoracic vertebra, where the ribs attach, and the pelvis (hip bone), are the lumbar vertebra. The sacral vertebra run from the pelvis to the end of the spinal column. Injuries to the five lumbar vertebra (L-1 thru L-5) and similarly to the five sacral vertebra (S-1 thru S-5) generally result in some loss of function in the hips and legs.
The effects of a spinal cord injury depend on the type and level of the injury. Spinal cord injuries can be divided into two types of injury complete and incomplete. A complete injury means there is no function below the level of the injury no sensation and no voluntary movement. Both sides of the body are equally affected.
An incomplete injury means there is some function below the primary level of injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other. With the advances in acute treatment of spinal cord injuries, incomplete injuries are becoming more common.
The level of injury is very helpful in predicting what parts of the body might be affected by paralysis and loss of function. Remember that in incomplete injuries, there will be some variation in these prognoses.
Cervical (neck) injuries usually result in quadriplegia. Injuries above the C-4 level may require a ventilator for the person to breathe. C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand. C-6 injuries generally yield wrist control, but no hand function.
Individuals with C-7 and T-1 injuries can straighten their arms, but still may have dexterity problems with the hand and fingers. Injuries at the thoracic level and below result in paraplegia, with the hands not affected. At T-1 to T-8, there is most often control of the hands, but poor trunk control resulting from a lack of abdominal muscle control. Lower thoracic injuries (T-9 to T-12) allow good trunk control and good abdominal muscle control. Sitting balance is very good. Lumbar and sacral injuries yield decreasing control of the hip flexors and legs.
Besides a loss of sensation or motor function, individuals with spinal cord injury also experience other changes. For example, they may experience dysfunction of the bowel and bladder. Very high injuries (C-1, C-2) can result in a loss of many involuntary functions, including the ability to breathe, necessitating breathing aids such as mechanical ventilators or diaphragmatic pacemakers.
Other effects of spinal cord injury may include low blood pressure, inability to regulate blood pressure effectively, reduced control of body temperature, inability to sweat below the level of injury and chronic pain.
In the United States, about 450,000 people are living with SCI. There are about 12,000 new SCIs every year, and the majority of them (82 percent) involve males between the ages of 16-30. These injuries result from motor vehicle accidents (36 percent), violence (28.9 percent) or falls (21.2 percent). Quadriplegia is slightly more common than paraplegia.
Currently, there is no cure for spinal cord injury. There are researchers studying this problem, and there have been many advances in the lab.
Many of the most exciting advances have resulted in a decrease in damage at the time of the injury. Steroid drugs, such as methylprednisolone, reduce swelling, which is a common cause of secondary damage at the time of injury.
When a spinal cord injury occurs, there is usually swelling of the spinal cord. This may cause changes in virtually every system in the body. After days or weeks, the swelling begins to go down, and people may regain some functioning. With many injuries, especially incomplete ones, the individual may recover some function as late as 18 months after the injury. In very rare cases, people with spinal cord injurywill regain some functioning years after the injury. However, only a small fraction of individuals sustaining a spinal cord injury recover all function.
No. Wheelchairs are a tool for mobility. High C-level injuries usually require the individual to use a power wheelchair. Low C-level injuries and below usually allow the person to use a manual chair. Advantages of manual chairs are that they cost less, weigh less, disassemble into smaller pieces and are more agile. However, for the person who needs a power chair, the independence afforded by the chair is worth the limitations.
Some people are able to use braces and crutches for ambulation. These methods of mobility do not mean the person will never use a wheelchair. Many people who use braces still find wheelchairs more useful for longer distances. However, the therapeutic and activity levels allowed by standing or walking briefly may make braces a reasonable alternative for some people.
Of course, people who use wheelchairs aren’t always in them. They drive, swim, fly planes, ski and do many activities out of their chair. If you hang around people who use wheelchairs long enough, you may see them sitting in the grass pulling weeds, sitting on your couch, or playing on the floor with children or pets. And, of course, people who use wheelchairs don’t sleep in them; they sleep in a bed.
Typically, yes. Before World War II, most people who sustained a spinal cord injury died within weeks of their injury from urinary dysfunction, respiratory infection or bedsores. With the advent of modern antibiotics, modern materials such as plastics and latex, and better procedures for dealing with the everyday issues of living with SCI, many people approach the lifespan of non-disabled individuals.
Long-term data collected by Shepherd Center and the Spinal Cord Injury Model Systems (SCIMS) show an increase in life expectancy for people who have lived 25 years or more with spinal cord injury. The survival rate at 25 or more years after injury is 60 percent; this number has been climbing steadily over the years. In addition, many of the leading indicators show the quality of that extended life expectancy is good.
Interestingly, other than level of injury, the type of rehabilitation facility used is the greatest indicator of long-term survival. This illustrates the importance of and difference made by going to a facility that specializes in spinal cord injury. People who use ventilators are at some increased danger of dying from pneumonia or respiratory infection, but modern technology is improving in that area as well. Pressure sores are another common cause of hospitalization and if not treated, can be fatal.
Overall, 85 percent of people with spinal cord injury who survive the first 24 hours are still alive 10 years later. The most common cause of death is due to diseases of the respiratory system, with most of these being due to pneumonia. In fact, pneumonia is the single leading cause of death throughout the entire 15-year period immediately following SCI for all age groups, both males and females, whites and non-whites, and people with quadriplegia.
The second leading cause of death is non-ischemic heart disease. These are almost always unexplained heart attacks often occurring among young people who have no previous history of underlying heart disease.
Deaths due to external causes are the third leading cause of death forpeople with spinal cord injury. These include subsequent unintentional injuries, suicides and homicides, but do not include people dying from multiple injuries sustained during the original accident. The majority of these deaths are the result of suicide.
Your spine is one of the most important parts of your body. It gives you structure and support. Without a spine, you would not be able to stand up and move freely. It is central to your skeletal system, it supports your head and encloses the spinal cord which runs down a canal in the spine.
Your spinal cord is a thick bundle of nerves, similar to a white fibre optic cable. It is usually about 43cm long and 2cm wide and is the communication link between your brain and other parts of your body.
The 31 pairs of spinal nerves in your spinal cord support a functional nervous system; a system you use whenever you think, see or breath.Messages about feeling or sensation are sent to the brain via the spinal cord, and the brain sends movement or functional messages to the body, also via the spinal cord. Damage to your spinal cord can have a profound impact on your life because once damaged it cannot be repaired.
This is why it is so vital to protect your spine and spinal cord. Read some real life stories about how spinal damage impacts lives.
In most cases, a spinal cord injury is permanent and irreversible. It is a traumatic and devastating experience for the individual, their family and friends. It changes their lives forever.
It can happen to anyone at any time. One person sustains a spinal cord injury every four days in Queensland about 90 people each year. There is no cure prevention is the key.
Spinal cord injury occurs if pressure is applied to the spinal cord, and/or the blood and oxygen supply to the cord is cut off. This can occur when the vertebrae of the spine, enclosing the spinal cord, are displaced or injured.
If the spinal cord is damaged through crushing, bruising or severing, the messages to and from the brain cannot get through. Generally, the level and degree of injury to the spinal cord will determine the extent and areas of paralysis.
The diagram illustrates the various levels of the spine and the extent of paralysis which occurs to the body when the spinal cord is injured at a certain level.
The main difference between paraplegia and quadriplegia relates to the extent of paralysis and loss of feeling in the limbs.
Spinal damage can also occur at the sacral or coccygeal levels. This affects the bowel, bladder and the leg area below the knee. However, many people who injure their spinal cord at this level will be able to walk with the assistance of special aids, such as a walking stick or foot splints.
The damage to the spinal cord may be complete or incomplete, depending on the degree of injury to the nerve fibres.
A complete spinal cord injury means there is complete loss of movement and feeling below the level of the injury. Damage has occurred to the whole spinal cord and no messages are getting past the area of damage. An incomplete spinal cord injury means there is some movement and feeling below the level of the injury. Only part of the spinal cord has been damaged and some messages are getting through.
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Source: Princess Alexandra Hospitals Spinal Injuries Unit 2012
According to the Spinal Cord Injury Network, more than 10,000 people in Australia have a spinal cord injury.
Source: Access Economics 2009
Source: National Disability Services 2010
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When treating a person with a spinal cord injury, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method. Furthermore, increasing activity will increase his/her chances of recovery.
The rehabilitation process following a spinal cord injury typically begins in the acute care setting. Occupational therapy plays an important role in the management of SCI. Recent studies emphasize the importance of early occupational therapy, started immediately after the client is stable. This process includes teaching of coping skills, and physical therapy. Physical therapists, occupational therapists, social workers, psychologists and other health care professionals typically work as a team under the coordination of a physiatrist to decide on goals with the patient and develop a plan of discharge that is appropriate for the patients condition. In the first step, the focus is on support and prevention. Interventions aim to give the individual a sense of control over a situation in which the patient likely feels little independence.
As the patient becomes more stable, they may move to a rehabilitation facility or remain in the acute care setting. The patient begins to take more of an active role in their rehabilitation at this stage and works with the team to develop reasonable functional goals.
In the acute phase physical and occupational therapists focus on the patients respiratory status, prevention of indirect complications (such as pressure sores), maintaining range of motion, and keeping available musculature active.
Depending on the Neurological Level of Impairment (NLI), the muscles responsible for expanding the thorax, which facilitate inhalation, may be affected. If the NLI is such that it affects some of the ventilatory muscles, more emphasis will then be placed on the muscles with intact function. For example, the intercostal muscles receive their innervation from T1T11, and if any are damaged, more emphasis will need to placed on the unaffected muscles which are innervated from higher levels of the CNS. As SCI patients suffer from reduced total lung capacity and tidal volume  it is pertinent that physical therapists teach SCI patients accessory breathing techniques (e.g. apical breathing, glossopharyngeal breathing, etc.) that typically are not taught to healthy individuals.
Physical therapists can assist immobilized patients with effective cough techniques, secretion clearance, stretching of the thoracic wall, and suggest abdominal support belts when necessary. The amount of time a patient is immobilized may depend on the level of the spinal cord injury. Physical therapists work with the patient to prevent any complications that may arise due to this immobilization. Other complications that arise from immobilization include muscle atrophy and osteoporosis, especially to the lower limbs, increasing the risk of fractures to the femur and tibia. While passive weight bearing of paralyzed lower extremities appears to be ineffective, stressing the bones through muscular contractions initiated by functional electrical stimulation (FES) has yielded positive results in some cases. The intensity, frequency, and duration of stress to the bones appear to be important determinants of improved bone parameters. Generally, the frequency is effective with three or more weekly exercise sessions. Studies of duration suggest that several months to one or more years of FES are necessary.
Improvement of locomotor function is one of the primary goals for people with a spinal cord injury. SCI treatments may focus on specific goals such as to restore walking or locomotion to an optimal level for the individual. The most effective way to restore locomotion is by complete repair, but techniques are not yet developed for regeneration. Treadmill training, over groundtraining, and functional electrical stimulation can all be used to improve walking or locomotor activity. These activities work if neurons of the central pattern generator (CPG) circuits, which generate rhythmic movements of the body, are still functioning. With inactivity, the neurons of CPG degenerate. Therefore, the above activities are important for keeping neurons active until regeneration activities are developed. A 2012 systematic review found insufficient evidence to conclude which locomotor training strategy improves walking function most for people with spinal cord injury. This suggests that it is not the type of training used, but the goals and the routines that have the biggest impact. Applying spinal cord stimulation (transcutaneous or epidurally) during weight supported walking have been shown to improve locomotor output.
Though rehabilitation interventions are performed during the acute phase, recent literature suggests that 44% of the total hours spent on rehabilitation during the first year after spinal cord injury, occur after discharge from inpatient rehabilitation. Participants in this study received 56% of their total physical therapy hours and 52% of their total occupational therapy hours after discharge. This suggests that inpatient rehabilitation lengths of stay are reduced and that post-discharge therapy may replace some of the inpatient treatment.
Whether patients are placed in inpatient rehabilitation or discharged, occupational therapists attempt to maximize functional independence at this stage. Depending on the level of the spinal cord injury, whatever sparing the patient has is optimized. Bed mobility, transfers, wheelchair mobility skills, and performing other activities of daily living (ADLs) are just a few of the interventions that occupational therapists can help the patient with. A major problem for spinal cord injury patients is restricted range of motion. Massage therapy has been used to aid in range of motion rehabilitation. Literature has shown that participants with spinal cord injuries that had massage therapy added into their rehabilitation had significant improvement observed by physical therapist in functional living activities and limb range of motion. This could be due to the decrease in H-Reflex amplitudes measured by EMG that is critical for the comfort of spinal cord injury patients for reducing cramps and spasms.
ADLs can be difficult for an individual with a spinal cord injury; however, through the rehabilitation process, individuals with SCI may be able to live independently in the community with or without full-time attendant care, depending on the level of their injury.
Further interventions focus on support and education for the individual and caregivers. This includes an evaluation of limb function to determine what the patient is capable of doing independently, and teaching the patient self-care skills. Independence in daily activities like eating, bowel and bladder management, and mobility is the goal, as obtaining competency in self-care tasks contributes significantly to an individual’s sense of self-confidence and reduces the burden on caregivers. Quality of life issues such as sexual health and function after spinal cord injury are also addressed.
Assistive devices such as wheelchairs have a substantial effect on the quality of life of the patient, and careful selection is important. Teaching the patient how to transfer from different positions, such as from a wheelchair into bed, is an important part of therapy, and devices such as sliding transfer boards and grab bars can assist in these tasks. Individuals who are able to transfer independently from their wheelchair to the driver’s seat using a sliding transfer board may be able to return to driving in an adapted vehicle. Complete independence with driving also requires the ability to load and unload one’s wheelchair from the vehicle. In addition to acquiring skills such as wheelchair transfers, individuals with a spinal cord injury can greatly benefit from exercise reconditioning. In the majority of cases, spinal cord injury leaves the lower limbs either entirely paralyzed, or with insufficient strength, endurance, or motor control to support safe and effective physical training. Therefore, most exercise training employs the use of arm crank ergometry, wheelchair ergometry, and swimming. In one study, subjects with traumatic spinal cord injury participated in a progressive exercise training program, which involved arm ergometry and resistance training. Subjects in the exercise group experienced significant increases in strength for almost all muscle groups when compared to the control group. Exercisers also reported less stress, fewer depressive symptoms, greater satisfaction with physical functioning, less pain, and better quality of life. Physical therapists are able to provide a variety of exercise interventions, including, passive range of motion exercises, upper body wheeling (arm crank ergometry), functional electrical stimulation, and electrically stimulated resistance exercises all of which can improve arterial function in those living with SCI. Physical therapists can improve the quality of life of individuals with spinal cord injury by developing exercise programs that are tailored to meet individual patient needs. Adapted physical activity equipment can also be used to allow for sport participation: for example, sit-skiis can be used by individuals with a spinal cord injury for cross-country or downhill skiing.
The patient’s living environment can also be modified to improve independence. For example, ramps or lifts can be added to a patient’s home, and part of rehabilitation involves investigating options for returning to previous interests as well as developing new pursuits. Community participation is an important aspect in maintaining quality of life.
Body weight supported treadmill training is another intervention that physiotherapists may assist with. Body weight supported treadmill training has been researched in an attempt to prevent bone loss in the lower extremities in individuals with spinal cord injury. Research has shown that early weight-bearing after acute spinal cord injury by standing or treadmill walking (5 times weekly for 25 weeks) resulted in no loss or only moderate loss in trabecular bone compared with immobilized subjects who lost 7-9% of trabecular bone at the tibia. Gait training with body weight support, among patients with incomplete spinal cord injuries, has also recently been shown to be more effective than conventional physiotherapy for improving the spatial-temporal and kinematic gait parameters.
A combination of Body weight supported treadmill training (BWSTT) and robotic-assisted BWSTT is being implemented into some training programs. The benefits include: (1) assist in reproducing leg movements and optimizing gait pattern (speed, step length, amplitude); (2) training sessions can be prolonged and walking speed can be adjusted, increasing motor outcome; (3) provides consistency of movement, where manual interventions/cues by a trainer may be variable (although a trainer should analyze the gait pattern and outcome measures of the training and supervise training). It is important to note that the patient must be an active participant during the robotic movements and try to move with the robot. This type of training would be implemented during the beginning of rehabilitation and progressed to independent locomotion as improvements are made. However, robotic-assisted BWSTT is expensive and often not affordable by physiotherapy clinics. As an alternative, the development of non-motorized exoskeletons are currently being investigated for patients with incomplete SCI. The development of the exoskeleton locomotor device would provide an inexpensive alternative to the robotic devices. The exoskeleton may be used in areas that can not afford robotic devices, or, in areas that can not provide adequate physiotherapy care.
Restorative neurology offers a different paradigm of treating spinal cord injury by focusing on the residual remaining motor control and on the intrinsic function of the sub-lesional spinal cord segments.
Causes of a spinal cord injury
Spinal cord injury (SCI) involves damage to the nerves within the bony protection of the spinal canal. The most common cause of SCI is trauma, although damage can occur from various diseases acquired at birth or later in life, from tumors, electric shock, poisoning or loss of oxygen related to surgical or underwater mishaps.
A common misconceptions is that a spinal cord injury means the spinal cord has to be severed in order for a loss of function to occur. In fact, most people who have sustained a SCI, the spinal cord is bruised and intact.
The spinal cord and the brain together make up the central nervous system (CNS). The spinal cord coordinates the body’s movement and sensation. Therefore, an injured cord loses the ability to send and receive messages from the brain to the body’s systems that control sensory, motor, and autonomic function below the level of injury. Often, this results in some level of paralysis.
Spinal cord injury is an age-old problem, but it wasn’t until the 1940s that the prognosis for long-term survival was very optimistic. Prior to World War II, people routinely died of infections to the urinary tract, lungs, or skin. SCI went from a death sentence to a manageable condition. Nowadays, people with spinal cord injury approach the full life span of nondisabled individuals.
Acute care following an injury may involve surgery if the spinal cord appears to be compressed by bone, a herniated disk, or a blood clot. Traditionally, surgeons waited for several days to decompress the spinal cord, believing that operating immediately could worsen the outcome. More recently, many surgeons advocate immediate early surgery.
Generally speaking, after the swelling of the spinal cord begins to go down, most people show some functional improvement after an injury.
With many injuries, especially incomplete injuries (some motor or sensory function preserved below the injury level), a person may recover function eighteen months or more after the injury. In some cases, people with SCI regain some function years after the injury. There is a lot of information and resources to learn about the effects of a spinal cord injury. However, it is important to understand the functions of the spinal cord and its relationship to the brain.
The spinal cord includes neurons and long nerve fibers called axons. Axons in the spinal cord carry signals downward from the brain (along descending pathways) and upward toward the brain (along ascending pathways).
Many axons in these pathways are covered by sheaths of an insulating substance called myelin, which gives them a whitish appearance. Therefore, the region in which they lie is called “white matter.” Loss of myelin, which can occur with cord trauma and is the hallmark of such diseases as multiple sclerosis, prevents effective transmission of nerve signals.
The nerve cells themselves, with their tree-like branches called dendrites that receive signals from other nerve cells, make up “gray matter.” This gray matter lies in a butterfly-shaped region in the center of the spinal cord.
Like the brain, the spinal cord is enclosed in three membranes (meninges):
The spinal cord is organized into segments along its length, noted by their position along the thirty-three vertebrae of the backbone. Nerves from each segment connect to specific regions of the body, and thus control motor and autonomic functions.
In general, the higher in the spinal column an injury occurs, the more function a person will lose.
Cervical region The segments in the neck, or cervical region, referred to as C1 through C8, control signals to the neck, arms, hands, and, in some cases, the diaphragm. Injuries to this area result in tetraplegia, or as it is more commonly called, quadriplegia.
Thoracic region Nerves in the thoracic or upper back region (T1 through T12) relay signals to the torso and some parts of the arms.
Lumbar and sacral regions
Besides a loss of sensation or motor function, injury to the spinal cord leads to other changes, including loss of bowel, bladder, and sexual function, low blood pressure, autonomic dysreflexia (for injuries above T6), deep vein thrombosis, spasticity, and chronic pain.
Other secondary issues related to injury include pressure ulcers, respiratory complications, urinary tract infections, pain, obesity, and depression.
These complications of a spinal cord injury are mainly preventable with good healthcare, diet, and physical activity.
Several types of cells carry out spinal cord functions, including:
All of these glial cells produce substances that support neuron survival and influence axon growth. However, these cells may also impede recovery following injury; some glial cells become reactive and thereby contribute to formation of growth-blocking scar tissue after injury.
Nerve cells of the brain and spinal cord respond to trauma and damage differently than most other cells of the body, including those in the peripheral nervous system (PNS). The brain and spinal cord are confined within bony cavities that protect them, but this also renders them vulnerable to compression damage caused by swelling or forceful injury.
Cells of the CNS have a very high rate of metabolism and rely upon blood glucose for energy these cells require a full blood supply for healthy functioning; therefore, CNS cells are particularly vulnerable to reductions in blood flow (ischemia).
Other unique features of the CNS are the “blood-brain-barrier” and the “blood-spinal-cord barrier.” These barriers, formed by cells lining blood vessels in the CNS, protect nerve cells by restricting entry of potentially harmful substances and cells of the immune system.
Trauma may compromise these barriers, potentially contributing to further damage in the brain and spinal cord. The blood-spinal-cord barrier also prevents entry of some therapeutic drugs.
What is the difference between a complete injury and an incomplete injury?
While there’s almost always hope of recovering some function after a spinal cord injury, it is generally true that people with incomplete injuries have a better chance of getting more return.
The sooner muscles start working again, the better the chances are of additional recovery. When muscles come back later, after the first several weeks, they are more likely to be in the arms than in the legs.
As long as there is some improvement and additional muscles recover function, the chances are better that more improvement is possible. The longer there is no improvement, the lower the odds it will start to happen on its own.
A sample of the insights gleaned from the research on the prevalence of SCI include:
These findings have major implications for the treatment of spinal cord and paralysis-related diseases not only for those living with these conditions, but also for their families, caregivers, healthcare providers, and employers.
People who sustain a spinal cord injury are mostly in their teens or twenties, although as the population in general ages, the percentage of older persons with paralysis is increasing.
As the number of people living with paralysis rise and as they age with the injury, the costs associated with treating them increase as well. Each year, paralysis costs the healthcare system billions of dollars. Spinal cord injuries alone cost roughly $40.5 billion annually a 317 percent increase from costs estimated in 1998 ($9.7 billion).
People living with paralysis and spinal cord injuries are also often unable to afford health insurance that adequately covers the complex secondary or chronic conditions that are commonly linked with paralysis.
Currently, there is no cure for spinal cord injuries. However, ongoing research to test surgical and drug therapies is progressing rapidly. Injury progression prevention drug treatments, decompression surgery, nerve cell transplantation, nerve regeneration, and complex drug therapies are all being examined as a means to overcome the effects of spinal cord injury.
The Reeve Foundation has been leading the charge in spinal cord research for over 30 years, creating a framework to translate scientific breakthroughs into vital new therapies. Additionally, we have established programs to help cultivate the next generation of researchers that will safeguard a pipeline of innovation across the field and speed the delivery of cures for spinal cord injury.
If you are looking for more information on spinal cord injury or have a specific question, our information specialists are available business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9am to 5pm ET.
Our Peer & Family Support Program also provides individualized support through a national peer-to-peer mentoring program.
Additionally, the Reeve Foundation maintains a SCI fact sheet with resources from trusted Reeve Foundation sources. Check out our repository of fact sheets on hundreds of topics ranging from state resources to secondary complications of paralysis.
We encourage you to also reach out to other SCI support groups and organizations, including:
Source: American Association of Neurological Surgeons, Craig Hospital, Christopher & Dana Reeve Foundation, The National Institute of Neurological Disorders and Stroke
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Spinal cord injury – Reeve Foundation
Spinal cord connects the brain to all the nerves in body. It passes through the center part of the spinal column and is protected by the surrounding vertebra (bone) and soft tissues. Any Injury to the Spinal Column due to trauma, tumor or infection can damage the spinal cord. The area where the spinal cord is injured dictates the level of function, as dysfunction develops below that specific level of injury. Spinal cord injuries are classified as either incomplete or complete. Incomplete injuries show preservation of some function below the injured level. Complete injuries are characterized by a total lack of both motor and sensory functions below the level of the injury.
Spinal cord injury presents with severe pain, limited mobility, or paralysis after a specific incident or trauma to the spine.
Patients with spinal cord injury need to be thoroughly examined to assess any preservation of function, including peri-anal and rectal examinations and testing of all reflexes and motor and sensory functions. Radiographic studies (x-rays, CT scan and MRI) need to be performed following the injury or later to identify the injured spinal column and the traversing spinal cord to identify any level that needs to be treated surgically to take the pressure off the spinal cord or to stabilize a damaged bony structure that is normally protecting the spinal cord.
Surgery to correct a spinal deformity that narrows the spinal canal is often performed but is unlikely to reverse any major spinal cord dysfunction; however, removing bone or disc material from the spinal canal in a timely basis can promote the recovery of an incompletely injured cord. Patients with cervical spinal fractures are often placed in traction to try to realign the spinal canal to relieve any ongoing pressure on the spinal cord. Some spinal injuries that result in spinal cord trauma are stable and do not require surgery. In the cervical spine, fractures are sometimes treated with immobilization devices such as a halo external fixation device. Unstable fractures in the thoraco-lumbar region may require instrumented fusion with bone screws or hooks connected together with metallic rods (fusion).
Spinal Cord Injury
Damage to the spinal cord usually results in impairments or loss of muscle movement, muscle control, sensation and body system control.
Presently, post-accident care for spinal cord injury patients focuses on extensive physical therapy, occupational therapy, and other rehabilitation therapies; teaching the injured person how to cope with their disability.
A number of published papers and case studies support the feasibility of treating spinal cord injury with allogeneic human umbilical cord tissue-derived stem cells and autologous bone marrow-derived stem cells.
Feasibility of combination allogeneic stem cell therapy for spinal cord injury: a case report co-authored by Stem Cell Institute Founder Dr. Neil Riordan references many of them. Published improvements include improved ASIA scores, improved bladder and/or bowel function, recovered sexual function, and increased muscle control.
The adult stem cells used to treat spinal cord injuries at the Stem Cell Institute come from two sources: the patients own bone marrow (autologous mesenchymal and CD34+) and human umbilical cord tissue(allogeneic mesenchymal). Umbilical cords are donated by mothers after normal, healthy births.
A licensed anesthesiologist harvests bone marrow from both hips under light general anesthesia in a hospital operating room. This procedure takes about 1 1/2 2 hours. Before they are administered to the patient, these bone marrow-derived stem cells must pass testing for quality, bacterial contamination (aerobic and anaerobic) and endotoxin.
All donated umbilical cords are screened for viruses and bacteria to International Blood Bank Standards.
Only about 1 in 10 donated umbilical cords pass our rigorous screening process.
Through retrospective analysis of our cases, weve identified proteins and genes that allow us to screen several hundred umbilical cord donations to find the ones that we know are most effective. We only use these cells and we call them golden cells.
We go through a very high throughput screening process to find cells that we know have the best anti-inflammatory activity, the best immune modulating capacity, and the best ability to stimulate regeneration.
The bodys immune system is unable to recognize umbilical cord-derived mesenchmyal stem cells as foreign and therefore they are not rejected. HUCT stem cells have been administered thousands of times at the Stem Cell Institute and there has never been a single instance rejection (graft vs. host disease). Umbilical cord-derived mesenchymal stem cells also proliferate/differentiate more efficiently than older cells, such as those found in the fat and therefore, they are considered to be more potent.
VIDEO Watch Professor Arnold Caplan explain how this works.
Our stem cell treatment protocol for spinal cord injury calls for a total of 16 injections over the course of 4 weeks.
The bone marrow-derived and umbilical cord tissue-derived stem cells are both administered intravenously by a licensed physician.
They are also injected intrathecally (into the spinal fluid) by an experienced anesthesiologist. Intrathecal injection enables the stem cells to bypass the blood-brain barrier and migrate to the injury site within the spinal canal.
Proper follow-up is essential for us to monitor your condition after treatment. It also helps us evaluate treatment efficacy and improve our protocols based on reported outcomes over time.
Therefore, one of our medical staff will be contacting you at the following intervals: 1 month, 3 months, 4 months, and 1 year.
Yes, we do. Several of our spinal cord injury patients currently volunteer to speak with prospective patients. Your patient coordinator will be happy to put you in touch with them once your treatment evaluation has been completed.
Weve also published written testimonials, news articles and videos from our spinal cord injury patients. Please take a look!
You may contact us by telephone 1 (800) 980-STEM (toll-free in US) and 1 (954) 358-3382.
To apply for stem cell treatment, please complete this stem cell therapy patient application form.
*Please not that the above treatment outline is typical. However, actual treatment scheduling might vary slightly.
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Stem Cell Therapy || Spinal Cord Injury || Stem Cell …
Traumatic brain injuries and spinal injuries are often permanent, always life-changing, and affect the lives of both victims and their families. These injuries, whether involving permanent paralysis or not, are often caused by the fault of others, whether by surgical error, birth injury, subway or train accident, automobile, truck or motorcycle collisions, construction site mishaps, playground accidents, slip and fall accidents, chemical exposure, defective products or machinery failures.
More than a million Americans experience a brain injury each year, whether a Traumatic Brain Injury (TBI), closed head injury, skull fracture, depressed skull injury, or brain bleed, and 80,000 people have long-term disabilities as a result of their injury. In fact, according to the National Center for Injury Prevention, 1.5 million Americans each year sustain a brain injury. Of those, 50,000 die and over 1 million are treated in hospitals. Many of these victims are children, who are most at risk. Almost 500,000 children suffer serious brain injuries as a result of accidents each year. Additionally, many construction workers suffer brain injuries due to the nature of their work.
Brain trauma is usually the result of a direct blow to the head, which can bruise the brain and damage its internal tissues and blood vessels. The severity of a head or brain injury can range from a mild concussion to a severe injury that results in coma or even death. In a closed head or brain injury, there is no break in the skull and the brain is jarred against the sides of the skull, shearing (or tearing) the internal lining, nerves, tissues, and blood vessels, causing bleeding, bruising, or swelling. These types of injuries are often classified as subdural hematomas, sub-arachnoid bleeds and epidural bleeds. In a penetrating or open head injury, the skull is broken.
The sudden and profound injury the brain sustains at the time of the accident is called the primary brain injury. It can be followed by secondary brain injury, a cascade of cellular, chemical, tissue, or blood vessel changes that evolve in the hours to days after the accident. These changes can further destroy brain tissue.
Spinal cord injuries affect between four and five million Americans yearly, and 400,000 live with the continuing effects of these injuries. Injuries to the neck(the cervical spine) or to the back (the lumbar spine) can result in serious damage to the spinal cord causing permanent, and often catastrophic injuries.
An injury to the spinal cord, the central carrier of signals throughout the body, may be simply a bruise (or contusion), or a partial or complete tear. A mild contusion may cause the temporary loss of some function below the site of the injury. A complete transection, or severing of the spinal cord, causes a total and permanent loss of sensation and movement below the site of the injury.
The spinal column is a flexible, mobile assemblage of individual segments of bone which are called vertebrae. There are seven cervical vertebrae (the neck), twelve thoracic vertebrae (chest) and five lumbar vertebrae (the back) all of which move with the structures above and below. The sacrum (located at the base of the lumbar vertebrae) consists of five vertebrae, all of which are fused forming a solid body. The coccyx (tailbone) is made up of four to five bony segments which are fused together to form one bone, although mobile on the sacrum.
The vertebrae are made up of the vertebral body, lying in front of or anterior to the spinal cord, and the posterior portion, which consists of the neural bony arch which is located on each side of and behind the spinal cord. The bodies of the vertebrae are connected together by the intervertebral disc structures (the tough ring of annulus fibrosis and the sem-gelatinous nucleus pulposus). On its upper or superior, and lower or inferior surfaces each vertebral body is covered with a thin plate of cartilage.
The posterior neural arch is divided into anatomical parts. The arch is connected to the vertebra body on both sides by what is known as the pedicel. The vertebra moves with that above and below not solely through the vertebral bodies but also through bilateral joints called the facets. The facets are located on the posterior neural arches. The facet articulating with the vertebra above is called the superior facet; that with the vertebra below is the inferior facet continuing from the facets posteriorly are the laminate, which meet with each other at the midline. Completing the boney neural arch from the midpoint of the neural arch, posteriorly and projecting backward is the spinous process, to which ligaments and muscles are attached.
The Intra Vertebral discs are interposed between the adjacent structures of the vertebral bodies from the second cervical vertebrae to the sacrum forming strong bonds between the adjacent vertebrae. Each intervertebral disc has two parts, the annulus fibrosis and the nucleus pulposus. The annulus fibrosis is made up of laminae (layers) of fibrous tissue. They are arranged concentrically; the outermost of fibrous tissues, the other of fibrocartilage. The annulus fibrosis surrounds the nucleus pulposus and can be compared to a retaining sheath of fibrous tissue. The tension of the elastic annulus fibrosis keeps the nucleus under pressure. The nucleus pulposus has a pulpy or mucoid consistency. Basically, a disc herniation occurs when the nucleus herniates (protrudes) the annulus fibrosis. Depending on the extent and direction of the herniation (anterior or posterior) the nucleus pulposus can encroach upon the spinal nerve roots and subject them to pressure and/or resulting pain in the areas of the body enervated by the effected nerve roots. Herniated discs may be caused by trauma, such as car, truck and bus accidents, construction accidents and other types of accidents which cause severe trauma to the spinal column. A posterior herniation may cause the nucleus pulposus to encroach on the spinal nerve roots causing severe pain and resulting disability for which surgery may be required.
Where brain injury or spinal injury is the result of someone else’s wrongful conduct, experienced attorneys are required. Your lawyer must be prepared to investigate, file suit, and prosecute your claim with intensity and passion. The New York brain and spinal cord injury attorneys at Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf have the experience, medical knowledge and courtroom track record necessary to make certain that you, or the loved one for whom you are responsible, obtain full compensation covering medical expense, rehabilitation cost, lost wages, supplies and equipment, loss of enjoyment of life and pain and suffering. Our lawyers have achieved outstanding results for our clients who suffer from quadriplegia, paralysis, or loss of brain function as a result of traumatic accidents.
The New York personal injury law firm of Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf is dedicated to the recovery of full and fair compensation for accident victims whose injuries include brain trauma or spinal cord damage. Our attorneys and staff have the skill and experience to obtain full and fair compensation for those who have sustained such injuries. Brain and spinal injured victims, as well as their families, need lawyers who understand the medical, physical, economic and psychological impacts of Traumatic Brain Injury(TBI) and Spinal Cord Injuries(SCI).
Quadriplegia, paraplegia and brain damage are catastrophic injuries involving damage to the Central Nervous System. Victims sustaining these types of injuries need attorneys who possess the extensive knowledge and experience necessary to secure proper and adequate compensation for those whose lives have been irreparably damaged. At Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf, our attorneys have extensive background and training in prosecuting cases in New York involving these and other types of injuries to the Central Nervous System. The brain and spinal cord, the two main components of the Central Nervous System, control neural function throughout the body. Knowledge of motor and sensory function is a key element in securing appropriate compensation for the victim of such an injury whether it be paralysis, paresis or brain injury. Not only do our attorneys have more experience in handling these types of injuries than other law firms, but we have obtained among the highest awards in the country for our clients. Indeed, our attorneys have such familiarity with these injuries that we are often called upon to teach and lecture to other attorneys at Continuing Legal Education (CLE) sponsored by educational associations throughout the United States.
At Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf, every case of this type is thoroughly prepared so that the present and future needs of the victim are accounted for both medically and financially. At the outset, we assemble a team of legal and medical experts chosen for their ability to analyze, document, and persuasively describe their findings with respect to every technical issue of liability and damages that will arise in your case. We consult nationally recognized experts in healthcare, medicine, and life care planning in order to ensure our clients receive full compensation. In cases involving paraplegia or quadriplegia, we work with established healthcare cost data that details known costs associated with current and future nursing care, medical equipment, and other needed medical care including the cost of wheelchairs and required changes to your home and your vehicle. A physical rehabilitative expert (a physiatrist) works with a life care planner to identify and address the physical, medical and day-to-day needs of the victim and individualized plans are prepared to insure that the victim can achieve some level of future independence and a meaningful quality of life. An economist is retained to analyze and quantify the medical costs associated with the life care plan and prepare a report that accounts for rising medical costs, interest and inflation. An experienced Trial Attorney is, in this way, equipped to present all of the damage issues to the jury in clear and understandable terms.
At Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf, we have obtained many of the largest awards in New York and the United States for clients who have sustained injuries to the Central Nervous System. This is due to our extensive knowledge and background in these types of cases, coupled with our meticulous preparation and attention to detail, which is well-known throughout New York. We pride ourselves in the work we have done for our clients who have suffered such life-altering injuries.
Our goal in all cases is to help you recover the money you will need to make the most of your life in the aftermath of a traumatic accident. For more information regarding our practice and how we can help you, contact a New York brain and spinal cord injury lawyer at Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf to schedule a free consultation.
Disclaimer: Please be advised that the results achieved in any given case depend upon the exact facts and circumstances of that case. Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf cannot guarantee a specific result in any legal matter. Any testimonial or case result listed on this site is based on an actual legal case and represents the results achieved in that particular case, and does not constitute a guarantee, warranty or prediction of the outcome of any other legal matter.
CIRM funds many projects seeking to better understand spinal cord injury and to translate those discoveries into new therapies.
If you want to learn more about CIRM funding decisions or make a comment directly to our board, join us at a public meeting. You can find agendas for upcoming public meetings on our meetings page.
Find Out More: Stem Cell FAQ | Stem Cell Videos | What We Fund
Find clinical trials: CIRM does not track stem cell clinical trials. If you or a family member is interested in participating in a clinical trial, please visit clinicaltrials.gov to find a trial near you.
About 250,000 people in the U.S. live with spinal cord injuries. Half of those are quadriplegic, with the paralysis impacting all four limbs to some extent. For those individuals the lifetime cost of managing their condition is estimated to be between $2 million and $3 million.
Spinal cord injury became the first condition targeted in a human clinical trial using cells made from embryonic stem cells. That trial, begun by Geron in 2010 and based on the findings of a team CIRM currently funds, was later cancelled by Geron for financial reasons. By the time of the cancellation five patients around the country had been enrolled in the study, including two at Stanford, who entered the trial during a period when CIRM funded Geron. Those patients continue to be followed to learn as much as possible about this approach.
Californias stem cell agency retains many grants for research to move potential spinal cord injury therapies forward (the full list is below). Much of this work focuses on trying to determine which type of nerve cell is the best one to transplant, and deciding which type of stem cell is the best starting point for making those cells. Other research is trying to see if these transplanted cells become part of the existing nerve system, helping create new pathways that can transmit nerve signals to muscles. The researchers are also looking at ways to try and improve the ability of these transplanted cells to become part of the nerve system.
One obstacle that some teams are trying to overcome is the tendency of the scar at the site of injury to block the growth of these transplanted cells. One group is trying to overcome that by combining stem cells with synthetic scaffolds that can be placed at the site of injury, to help the cells bridge the scar and restore signals. In animal models this combination has resulted in an increase in mobility compared to stem cell grafts alone.
Progress and Promise toward a stem cell-based therapy for spinal cord injury
Read more from the original source:
Spinal Cord Injury Fact Sheet | California’s Stem Cell Agency
The University of Florida is a comprehensive, state of Florida-accredited, Spinal Cord Injury Center.
The Spine Team is under the direction of:
Spinal Cord Injury (SCI) is damage to the spinal cord that results in a loss of function below the level of the lesion, including paralysis, sensory loss, bowel/bladder/sexual dysfunction. SCI most commonly occurs after trauma, however there other causes including pathologic fractures, spinal tumors, spinal infections, and congenital spinal anomalies.
There are currently over 450,000 people in the US with spinal cord injuries. About 10,000 new SCIs occur each year of which the majority of are males between the ages of 16-30. Spinal trauma typically results from motor vehicle accidents, violent acts, and falls.
The spinal cord is a neural structure that extends from the base of the brain, down the middle of the back, to level of the waist. The spinal cord carries nerve fibers from the brain to nerve cells at each level of the cord. The fibers from these segmental nerve cells leave the cord through the spinal nerves. These spinal nerves exit at each vertebral level and communicate with specific areas of the body. There are both motor and sensory portions of the spinal nerves.
Rings of bone called vertebrae surround the spinal cord. The stacked vertebrae create the spinal column, which provide the support for the body. There are seven cervical vertebrae. The cervical bones are designed to allow flexion, extension, and rotation of the head. In the chest region, the thoracic spine attaches to the ribs. There are twelve vertebrae in the thoracic region. There are five vertebrae in the lumbar spine. The lowest lumbar vertebra articulates with the sacrum. The sacrum attaches to the pelvis.
SCI is the result of damage to the spinal cord from severing, stretch, or compression.
SCI can be divided into two types:
A complete injury means that there is no function below the level of the injury, i.e. no sensation and no voluntary movement. An incomplete injury means that there is some function below the primary level of the injury. A person with an incomplete injury may be able to move one limb or may be able to feel parts of the body that cannot be moved. The type of SCI is important in prognosis and return of function. Complete injuries tend to have little recovery, while incomplete injuries usually have some degree of improvement.
In general, the higher in the spinal column the spinal cord injury occurs, the more neurological dysfunction a person will experience.
Injuries between C-1 and C-4 are very critical because they impair the ability to breath. C-5 injuries result in good shoulder and biceps control, but no control at the wrist or hand and legs. C-6 injuries generally yield wrist control, but no hand or leg function. Individuals with C-7 and T-1 injuries can straighten their arms but still have dexterity problems with the hand and fingers. Injuries at the thoracic level and below result in paraplegia, with the hands not affected. High lumbar injuries affect the ability of the hip to flex and extend the legs, while lower lumbar injuries affect the mobility of the lower parts of the leg.
Often with SCI there is significant loss of bowel or bladder function. This can occur with injuries at any level. Sexual functioning is frequently affected by SCI. Other effects of SCI may include inability to regulate blood pressure effectively, reduced control of body temperature, inability to sweat below the level of injury, and chronic pain.
The diagnosis of SCI is made by a detailed neurological examination. Plain radiographs and CT scans of the spine will show any significant fractures of the bones. MRI of the spine will show any injury to the actual spinal cord.
Because of the force that is required to fracture the spine, many spinal cord-injured patients suffer have significant associated injuries in the chest or abdomen. For isolated spinal cord injuries the mortality after one year is about 5-7%. If a patient survives the first 24 hours after spinal cord injury, the likelihood of survival for ten years is approximately 75-80%.
The immediate treatment of SCI is stabilization of the spine to prevent any further injury to the spinal cord. Within the first 24 hours, steroid drugs such as methylprednisolone are used to reduce swelling in the spinal cord. The benefit of steroids is limited and it has been shown to be useful only for a 24-hour period.
Surgery is indicated when there is significant instability of the spine or if there is compression of the spinal cord with an incomplete SCI. This may be a result of fractured bones or hematomas. Severe fractures may involve several columns of support in the spine, which will require surgical fixation to regain stability. Surgical fixation involves both instrumentation and fusion. Fusion is the joining of two vertebrae with bone graft (either from the patient or from cadaver) held together with metal hardware such as plates, rods, hooks, screws, and cages. The goal of the bone graft is to join the vertebrae above and below to form one solid piece of bone. It may take several months or longer to create a solid fusion. The instrumentation holds the bones together while the fusion is taking place.
Once stabilized, the goal of SCI treatment is rapid rehabilitation with the help of physical medicine specialists, physical therapists, occupational therapists, psychologists, and social workers. Patients must have a strong social support system to help them cope with their injury and relearn how to perform daily activities.
Originally posted here:
Spinal Cord Injury Department of Neurosurgery University
Spinal cord injuries are caused when delicate spinal cord tissue is bruised, torn, or crushed. Spinal cord injuries can be caused by accidents, but can also be caused by diseases or disorders.
Types of Spinal Cord Injury | Complete (Traumatic) |Incomplete (non-traumatic)
As many as 400,000 Americans are living with spinal cord injuries. Most spinal cord injuries occur between the ages of 16 and 30, and about 82 percent of those who experience spinal cord injuries are male. Motor vehicle accidents account for approximately 44 percent of all spinal cord injuries. Other common causes include:
After the spinal cord has been injured, messages no longer flow through the damaged area, essentially cutting off information between the brain and certain parts of the body. Generally, the functions of the body located above the point of injury will continue to work with no loss of function, while the areas of the body located below the point of injury will be impaired. Impairment can include the following:
Doctors and specialists use the level of injury to most accurately predict which parts of the body are most likely to be affected by loss of movement and sensation. Complete injuries will result in total loss of movement and sensation below the point of injury, while incomplete injuries will result in some degree of loss of movement and sensation below the point of injury. Levels of injury are classified as:
The prognosis of a particular spinal cord injury varies depending upon where along the spinal column the spinal cord has been injured, the severity of the injury, and which nerve fibers are damaged. These things can be narrowed down by distinguishing between symptoms like facial paralysis or periodic paralysis. As a general rule of thumb, some recovery can be expected within the first six months following injury. After six months, additional recovery becomes even harder and is why it is important to begin a rehabilitation program as soon as possible after an injury.
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Spinal Cord Injury | BrainAndSpinalCord.org
Contact the Spinal Program
The spinal cord serves not just one critical function, but several. A compact but extremely powerful package of nerves, it works with the brain to transmit important messages that are responsible for functions in every area of the body.
Because the spinal cord plays such an essential role, any injury has the potential for widespread and serious damage. Spinal cord injuries (SCIs) can occur as:
bruises (called contusions) partial tears complete tears (called a transection)
To understand how and why spinal cord injuries have different effects on different parts of the body, its helpful to understand the anatomy of the surrounding area. The spinal cord is divided into sections that correspond with the neighboring bones of the spine:
cervical (neck area) thoracic (mid-back) lumbar (lower back) sacrum (base of the spine)
Typically, the higher the location of the injury, the more significant the resulting damage. Serious SCIs are categorized as either paraplegicresulting in a loss of sensation and function in the lower half of the bodyor quadriplegic/tetraplegic, resulting in a loss of feeling and movement from the chest down, including both arms and both legs.
In addition, SCIs can be:
incomplete, causing only a partial loss of feeling and movement below the level of the injury complete, causing a complete loss of sensation and function below the level of the injury
Here are some of the statistics on spinal cord injuries:
Children account for only 5 percent of all individuals who sustain spinal cord injuries. 60 to 75 percent of all SCI occur in the neck area. 20 percent of all SCI affect the chest or upper back. The remaining 5 to 20 percent involve the spinal cord in the lower back.
While treatment options depend on the specifics and severity of the particular injury, you can rest assured that Boston Childrens Hospital has the world-renowned expertise and state-of-the-art tools to give you, your child and your family the care you need.
How Boston Childrens Hospital approaches spinal cord injuries
Learning that your child has a spinal cord injury is a frightening and potentially life-changing moment for any parent. Boston Childrens Hospital is here to work with you, your child and your family through every moment of your journey.
Boston Childrens Spinal Program is acclaimed both nationally and internationally for our excellence in diagnosing, treating and managing spinal cord injuries in children of all ages. In fact, our program:
centers on close collaboration between our experts in neurosurgery and orthopedics treats more than 6,000 children on an outpatient basis every year performs more than 300 spinal surgeries annually coordinates the full spectrum of support services for children with SCIs, including:
– physical therapy – occupational therapy – incontinence support – psychological support and counseling
Working together, our clinicians will develop a customized treatment plan that meets your child’s medical, emotional and practical needsand involves you and your family at every step of the way.
Spinal cord injury: Reviewed by Mark R. Proctor, MD Boston Childrens Hospital; posted in 2011
See more here:
Spinal Cord Injury | Boston Children’s Hospital
Spinal cord injury: Introduction
Spinal cord injury: Spinal cord injury (SCI) occurs when a traumatic event results in damage to cells within the spinal cord or severs the nerve tracts that … more about Spinal cord injury.
Spinal cord injury: Spinal cord injury is damage to the spinal cord as a result of a direct trauma to the spinal cord itself or as a result of indirect damage to the bones and soft tissues and vessels surrounding the spinal cord. More detailed information about the symptoms, causes, and treatments of Spinal cord injury is available below.
See full list of 12 symptoms of Spinal cord injury
See full list of 8 treatments for Spinal cord injury
Home medical testing related to Spinal cord injury:
Read more about Deaths and Spinal cord injury.
Read more about Types of Spinal cord injury
Review possible medical complications related to Spinal cord injury:
See full list of 6 causes of Spinal cord injury
More information about causes of Spinal cord injury:
Research the causes of these diseases that are similar to, or related to, Spinal cord injury:
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Research related physicians and medical specialists:
Other doctor, physician and specialist research services:
Medical research articles related to Spinal cord injury include:
Click here to find more evidence-based articles on the TRIP Database
More Spinal cord injury animations & videos
Prognosis for Spinal cord injury: People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel dysfunction, along with an increased susceptibility to respiratory and heart problems.
More about prognosis of Spinal cord injury
Visit our research pages for current research about Spinal cord injury treatments.
The US based website ClinicalTrials.gov lists information on both federally and privately supported clinical trials using human volunteers.
Some of the clinical trials listed on ClinicalTrials.gov for Spinal cord injury include:
See full list of 86 Clinical Trials for Spinal cord injury
Types of Spinal cord injury
Related forums and medical stories:
Read about other experiences, ask a question about Spinal cord injury, or answer someone else’s question, on our message boards:
Spinal cord injury (SCI) occurs when a traumatic event results in damage to cells within the spinal cord or severs the nerve tracts that relay signals up and down the spinal cord. The most common types of SCI include contusion (bruising of the spinal cord) and compression (caused by pressure on the spinal cord). Other types of injuries include lacerations (severing or tearing of some nerve fibers, such as damage caused by a gun shot wound), and central cord syndrome (specific damage to the corticospinal tracts of the cervical region of the spinal cord). (Source: excerpt from NINDS Spinal Cord Injury Information Page: NINDS)
Tools & Services:
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Spinal cord injury Symptoms, Diagnosis, Treatments and Causes …
United Spinal Association is dedicated to enhancing the quality of life of all people living with spinal cord injuries and disorders (SCI/D), includingveterans, and providing support and information to loved ones, care providers and professionals.
We believe no person should be excluded from opportunity on the basis of their disability. Our goal is to provide people living with SCI/D programs and services that maximize their independence and enable them to remain active in their communities.
United Spinal was founded in 1946 by a determined group of paralyzed WWII veterans in New York City who advocated for greater civil rights and independence for themselves and their fellow veterans. Rejecting the poor treatment they received at their local VA hospital, they decided to form a support group. From these modest beginnings, United Spinal was born. Since then, our core belief has remained unchanged. Despite living with SCI/D, a full, productive, and rewarding life is within the reach of anyone with the strength to believe it and the courage to make it happen.
Today, United Spinal is the largest non-profit organization dedicated to helping people living with SCI/D. We are committed to providing active-lifestyle information, peer support and advocacy that empower individuals to achieve their highest potential in all facets of life.
Each year, United Spinal helps thousands of wheelchair-users, veterans, and people with multiple sclerosis and other spinal cord disorders overcome the daily challenges of living with a disability. And we extend our support to those most important in their lives their family members and caregivers. We have more than 60 local chapters and support groups nationwide, connecting people with SCI/D to their peers and fostering an expansive grassroots network that enriches lives.
United Spinals members include individuals of all ages and backgrounds who are driven, independent, and active participants in our society. They are paralympians, wounded warriors, talented artists, kids with big dreams, proud parents, self-advocates, heroes, survivors, and accomplished professionals. We are committed to educating and empowering individuals with SCI/D to achieve and maintain the highest levels of independence, health and personal fulfillment.
Our membership community provides a lifeline for many individuals that are focused on regaining their independence and improving their quality of lifewhether they are leaving rehab after sustaining a spinal cord injury, learning to live with symptoms of a spinal cord disorder, or have spent years of frustration coping with disability. We provide members guidance and resources on a variety of topics they are passionate about, such as employment, affordable housing, transportation, health care, home- and community-based independent living, education, peer support, and leisure and recreation.
United Spinal is committed to advancing public policies that lead to greater civil rights and independence for people with disabilities.
Throughout our history, we have advocated on behalf of individuals living with SCI/D through state and federal legislation and accessibility litigation in the courts. Our members know that we are on their side, and will remain there until our support is no longer needed.
By leveraging all of our resources, we have stronger involvement in community affairs and more opportunities to advance public policies. This allows us to form key alliances that expand the reach of our mission. Our public policy initiatives focus on expanding education and employment, improving enforcement of the Americans with Disabilities Act (ADA), ensuring adequate access to public transportation and taxi services, and amending Medicare rules that restrict many individuals to their homes and nursing facilities.
We believe in: Access to Quality Affordable Healthcare Employment Opportunities, Self Sufficiency and Independent Living Consumer Directed Quality Health Care and Community Integration Preservation of Social Security Benefits Protecting the Rights of People with Disabilities
Learn more about our Public Policy Priorities.
Disability awareness has always been an integral part of United Spinals mission and culture. Our aim is to raise public awareness on the often-overlooked disability issues that affect our community. Maintaining the highest standards in communications, we promote our mission through our websites; social media pages; press releases; magazines and informative publications; participatory events and instructional sessions; public service announcements; and e-mail alerts. But the greatest asset in spreading our message has always been our members and supporters who believe in the work we do.
Informative Publications United Spinal provides a diverse selection of educational and informative publications. More information
Membership Magazine United Spinals New Mobility Magazine covers a diverse selection of contemporary topics that are of interest to wheelchair users. It also includes the latest United Spinal chapter-related news as well as member profiles and updates on major program initiatives.
The Buoniconti Fund supports cutting edge research at The Miami Project to Cure Paralysis at the University of Miami Miller School of Medicine, and serves as a clear leader in funding cures for paralysis. With The Miami Projects Christine E. Lynn Human Clinical Initiative, there are currently five FDA approved clinical trials for people with both acute and chronic spinal cord injuries. We are transplanting both Schwann cells and Stem cells back into the injured spinal cord, and we are the ONLY research group in the world with FDA Approval to combine cellular transplantations with intensive rehabilitation therapy.
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About | United Spinal Resource Center
UC San Diego Health System has a multidisciplinary program for restoring functionto people with spinal cord injuries.
Unlike the peripheral nerves, cells in the spinal cord do not regenerate after an injury.Damage to the spinal cord can impact body function, strength and sensation, causing loss of feeling, weakness and paralysis.
Breathing using phrenic nerve pacer or ventilator.
Basic arm function (elbowflexion) using a nerve transfer.
Grasp and release function, and triceps function
More sophisticated grasp and release and finer hand movements.
*NOTE: All patients with some movement in lower extremities may be considered as candidates for epidural stimulation to improve movement or reduce spasms.
Using epidural spinal cord stimulation, we can improve standing and walking in people who havecervical and thoraciclevel injury.
Recovering even partial arm and hand function after a spinal cord injury can have an enormous impact on independence and quality of life. Our surgeons use the latest surgical techniques and treatments to improve level of functioning.
Surgical and nonsurgical treatment techniques we use:
In the United States, there are approximately:
The human spinal cord is divided into 31 segments. A spinal cord injury is classified depending on where it occurs:
When the spinal cord is damaged, all functions below the point of injury are affected. This means that the higher the injury, the more dysfunction can occur. Our team can help bring back life to paralyzed limbs for all levels of injury through the latest surgical techniques.
Spinal cord injuries are either complete or incomplete. In a complete SCI, the brain and spinal cord are unable to communicate with the rest of the body below the point of injury. In an incomplete SCI, the spinal cord still has the ability to send messages from or to the brain.
The impact of a spinal cord injury on overall bodily function is assessed by the American Spinal Injury Association (ASIA) impairment scale.
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Spinal Cord Injuries – UC San Diego Health
Frank Amprim An ATV accident left Frank with a broken back and a prognosis that hed never run again. One year later, Frank is running his first 5K, and his therapist is running right beside him. Clickhere to read his story.
Spinal Cord Injury Rehabilitation Not all spinal cord injuries are alike, nor are all rehabilitation programs the same. Therefore, choosing the right rehabilitation program for someone with a spinal cord injury can make all the difference in the world.
RIM offers the regions most comprehensive approach to spinal cord injury rehabilitation.
Our commitment to excellence in SCI rehabilitation is reflected in our accreditation by The Commission on Accreditation of Rehabilitation Facilities (CARF) as a Spinal Cord System of Care, the only program in southeast Michigan with that specialty accreditation.
But what makes RIMs SCI program truly unique is that it addresses the entire spectrum of rehabilitation care for spinal cord injury. The program has four distinct phases. Click on the links below to learn more about each phase.
The program also includes a comprehensive list of specialty services that take into account the multitude of needs and quality of life of people with spinal cord injuries, from the earliest stages to a lifetime of health, sports, and fitness.
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Spinal Cord Injury – DMC RIM Rehab
The spinal cord consists of the nerves which connect the brain with the body, and is located in the spinal canal. The spinal canal lies inside the human vertebral column or spine, which is formed by all the vertebrae, the intervertebral discs and ligaments – (More information, including pictures, on the human spinal cord can be found here.)
Spinal cord injuries (SCI’s) have the potential to cause both loss of sensation and movement below the site of injury in persons who experience them. People may experience a spinal cord injury through trauma to the spine; for example in either a fall, or through a car accident.
People may experience a spinal cord injury which is either incomplete or complete.
In persons who have experienced an incomplete spinal cord injury, they may have some level of both feeling and movement remaining below the site of their injury. Persons with SCI may experience additional issues involving control of urination and bowel movements. People who have spinal cord injuries involving their neck many times require specific devices in order to assist them with breathing.
Terms such as, ‘Paraplegia,’ ‘Quadriplegia,’ and, ‘Tetraplegia,’ are used to describe medical conditions associated with persons who have experienced a spinal cord injury. The terms are used in classifications based on the level and severity of the injury the person has sustained and the affect on their limbs. Persons who live with SCI often find a need to change aspects of both the home and work environments in order to accommodate their disability; however, they continue to live fulfilling and productive lives.
Common Causes of Spinal Cord Injuries
Car accidents are a common cause of SCI – where the spine breaks and exerts pressure on or tears all or a part of the spinal cord; however, there are a number of other causes. Sports injuries, falls, and gunshot wounds are other causes of SCI’s. Diseases such as Spina Bifida, Polio, Transverse Myelitis, and Friedreich’s Ataxia also cause spinal cord injuries. Damage done to the person’s spinal cord may be referred to as a, ‘Lesion.’ The level of paralysis the person experiences may be referred to as Quadriplegia or Quadriplegia/Tetraplegia if the injury they have sustained is located in their neck area. If the injury they have sustained is in their Lumbar, Thoracic, or Sacral region, the injury may be referred to as Paraplegia.
There is the potential for a person to experience an injury to either their back or neck, resulting in a fracture, without paralysis. If the person’s vertebrae have been fractured or dislocated, but their spinal cord has not been damaged, paralysis may not occur. Spinal cord injury is a defining issue in association with SCI.
Complete and Incomplete Spinal Cord Injury
The terms, ‘Complete,’ and, ‘Incomplete,’ in reference to a spinal cord injury are associated with the type of lesion in the person’s spine.
Persons with incomplete SCI might have some sensation below the lesion, yet have no movement. There are a number of types of incomplete spinal cord injuries. Every person with an incomplete spinal cord injury is unique in regards to their injury.
Spinal column showing numbered vertebrae
Spinal Cord Injury Rehabilitation
Persons with SCI face a path of rehabilitation that can be lengthy.
The rehabilitation process often involves a Spinal Cord Injury Treatment Unit, Rehabilitation Center, or Spinal Injury Unit.
Cervical (neck) injuries usually result in full or partial tetraplegia (Quadriplegia). However, depending on the specific location and severity of trauma, limited function may be retained. See the list of C1 to S5 Vertebra functions.
Spinal Cord Injuries (SCI) Include:
Flexion Fracture Pattern
Extension Fracture Pattern
Rotation Fracture Pattern
ASIA SCI Classification
The American Spinal Injury Association (ASIA) first published an international classification of spinal cord injury in 1982, called the International Standards for Neurological and Functional Classification of Spinal Cord Injury.
A – Indicates a “complete” spinal cord injury where no motor or sensory function is preserved in the sacral segments S4-S5.
B – Indicates an “incomplete” spinal cord injury where sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5. This is typically a transient phase and if the person recovers any motor function below the neurological level, that person essentially becomes a motor incomplete, i.e. ASIA C or D.
C – Indicates an “incomplete” spinal cord injury where motor function is preserved below the neurological level, and MORE than half of key muscles below the single neurological level of injury have a muscle grade less than 3 (i.e. M 0 – no contraction, no muscle movement, M 1 – trace of contraction, but no movement, or M 2 – movement with gravity eliminated).
D – Indicates an “incomplete” spinal cord injury where motor function is preserved below the neurological level and at least half of the key muscles ( more than 50 percent of the key muscles) below the neurological level have a muscle grade of 3 or more (I.e. M3, M4 or M5, muscle can movement against gravity (3) or with additional resistance (4 & 5)).
E – If motor and sensation function with ISNCSCI are all graded normal (in all segments) and the patient had neurological deficits from SCI before, then the grade is E.
Note: only patients with SCI receive any AIS grade. The following incomplete syndromes are not part of the International Standards examination : central cord syndrome, Brown -Sequard syndrome, anterior cord syndrome, cauda equina syndrome, conus medullaris syndrome and all neurological deficits caused by lesion of lower motor neurons, i.e. brachial plexus lesions.
There is currently no cure for the paralysis associated with spinal cord injuries.
However, there are currently clinical trials being performed involving Olfactory Ensheathing Glial (OEG) cells and Embryonic Stem Cells that show promise.
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Spinal Cord Injury (SCI): Types & Treatment News …
When searching for spinal cord injury memoir products, Amazon customers prefer the following products. We have a comprehensive set of reviews from our customers on these kinds of products. Below we’ve selected a set of related products and the corresponding reviews to help you choose the product that best suits your needs.
An auto accident at 17 broke Mr. Neville’s neck but, thankfully, did not sever his spinal cord. The injury was so severe- and so high up- that even his ability to breathe was impaired. One doctor callously told him that he’d always be bedridden. But Neville had no intention of accepting that. He tackled physical and occupational therapy with gusto and managed to get back mobility in his arms. He went on to finish high school on time, earn two college degrees, and become not just employed but highly successful. So much for bedridden! He has achieved all that he dreamed of as a young man.
This is the story of how he accomplished all this. He had faith that his life had meaning and that giving up wasn’t in the plan. He also had an incredible support system in his family and friends, who were there for him … full review
Across The Street From Hell isn’t just a good must read book, it’s actually an honest look into Mr. Hall’s life. His story is inspirational to anyone who has had to overcome a major life changing event. I highly commend Mr. Hall for sharing his life with us.
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I found out about Shane’s accident by accident – an irony. A mutual friend mentioned it in passing. I also found out about his and Elly’s book by accident. It popped up in my Facebook feed. Providentially, a long train journey afforded me to opportunity to read this book in one sitting and I do wonder what my fellow travellers were making of my gasps, my tears, my laughs and my ‘Oh noes’.
It’s one of those books – deeply personal, brutally (and necessarily) honest and engaging.
I do think knowing someone you’re reading about adds an intensity to their story; however, the beauty of this book is that Shane and Elly don’t hold back. The result is 2 very clear, strong and real voices who invite you into their world with such intimacy that you will put the book down feeling that you know them too.
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This book should be placed where anyone with a spinal cord injury can read it. These young ladies’ story is a true life account of the adversities they meet and their sprit and determination to move forward with their dreams. They do not “hope” for a good life they make it happen.
[[ASIN:1921919159 WINDOWS IN THE CLOUDS]]
There are plenty of autobiographies out there about the rich and famous but this is a story of an ordinary Aussie bloke who has been on an extraordinary journey. From young, fit and healthy with the whole world before him, Stephen woke up one day in a hospital bed with the whole world having collapsed on him. This is the inspiring story of how he came to terms with his new life and then decided to take on some of the challenges he had dreamed of before his accident.
With a healthy dose of Aussie self-deprecating humour, he tells his story in a personal way that engages the reader and makes you want to know what he will do next.
Many people have so many excuses in life about why they haven’t done certain things. Stephen has shown us that most of … full review
Out of Print–Limited Availability.
To do justice to this book, read it with an open, searching heart. Then ask yourself, as this author did, what would YOU feel and what would YOU do if your child, an adolescent, was left paralyzed from the neck down? In those first days when your child couldn’t even speak what would you think about? That’s the painful situation author Richard Galli found himself facing after his son Jeffrey was paralyzed after a freak accident in a swimming pool, an accident which left him unable to move from the neck down. This account is a heartfelt, painfully honest description of the first ten days after the accident (when Jeffrey is basically unconscious) and what many readers have found hard to believe is how Jeffrey’s father could contemplate ending his son’s life. But I understood how his understanding of the life his son had lived before the accident … full review
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Half-Life Is Restoration of Body & Mind Moved back and forth in timeline, a bit repetitive with some events. Still was an interesting and heart rendering read.
This book is more than just a memoir. Derek Hawkins’ utter honesty about his life, his emotions and himself give the reader such a sense of the remarkable person he is that you feel as if he has done more than simply share his triumph over adversity. Although he says that he has always wanted to write about the events of his life and that doing so brings a form of closure, he has clearly given every reader a complex and fulfilling gift of spirit as well. And while we can admire, praise and compliment him for his pure courage, unassuming fortitude and inspiring perseverance, I hope this does not close the door on his writing career, so that in the future he will continue to gift readers with other thoughtful, humorous and rewarding works.
Available for download now.
A GREAT AVENUE FOR EXPERIENCING LIFE THROUGH THE EYES OF ANOTHER. LIFE’S LESSONS WITHOUT THE PAIN. A GOLDEN PRESCRIPTION. ITS WORTH GOING AFTER.
I have a spinal cord injury and found this book extremely inspiring. It’s helping me give up the wheelchair and move forward. Thanks, Grant!
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Spinal Cord Injury Memoir: Amazon.com