Spinal Cord Injury

Treatment

Specific treatment for an acute spinal cord injury will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the SCI
  • Type of SCI
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the SCI
  • Your opinion or preference

SCI requires emergency medical attention on the scene of the accident or injury. This is accomplished by immobilizing the head and neck areas to prevent the patient from moving. This may be very difficult since the victim and/or bystanders may be very frightened after the traumatic incident.

There is currently no way to repair a damaged or bruised spinal cord, though researchers are actively seeking means of stimulating spinal cord regeneration. The severity of the SCI and the location determines if the SCI is mild, severe, or fatal.

Surgery is sometimes necessary to, stabilize fractured back bones, decompress (or release) the pressure from the injured area, and to manage any other injuries that may have been a result of the accident. Treatment is individualized, depending on the extent of the condition and the presence of other injuries.

Treatments may include:

  • Observation and medical management in the intensive care unit (ICU)
  • Medications, such as corticosteroids (to help decrease the swelling in the spinal cord)
  • Mechanical ventilator, a breathing machine (to help the patient breathe)
  • Foley catheter — a tube that is placed into the bladder that helps to drain the urine into a collection bag.
  • Feeding tube (placed through the nostril to the stomach, or directly through the abdomen into the stomach, to provide extra nutrition and calories)

Recovery from a SCI requires long-term hospitalization and rehabilitation. An interdisciplinary team of physicians, nurses, therapists (physical, occupational, or speech), and other specialists work to medically manage the patient to control pain, to monitor the

  • Heart function
  • Blood pressure
  • Body temperature
  • Nutritional status
  • Bladder and bowel function and
  • Spasticity (attempt to control involuntary muscle shaking)

Rehabilitation focuses on preventing muscle wasting and contractures, and works to retrain the patient to use other muscles to aid in mobility and movement.

Life-long considerations for a person with a SCI

A traumatic event that results in a SCI is devastating to the person and the family. The healthcare team educates the family after hospitalization and rehabilitation on how to best care for the person at home and outlines specific clinical problems that require immediate medical attention by the patient’s physician.

The disabled person requires a focus on maximizing his/her capabilities at home and in the community. Positive reinforcement will encourage him/her to strengthen his/her self-esteem and promote independence.

A person with a SCI requires frequent medical evaluations and diagnostic testing following hospitalization and rehabilitation to monitor his/her progress.

Rehabilitation potential with SCI

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.

Level of injury Possible impairment Rehabilitation potential
C2 – C3 Usually fatal as a result of inability to breathe Totally dependent for all cares
C4 Quadriplegia and breathing difficulty Dependent for all cares; usually needs a ventilator
C-5 Quadripapresis with some shoulder and elbow function May be able to feed self using assistive devices; usually can breathe without a ventilator, but may need other types of respiratory support
C6 Quadripapresis with shoulder, elbow, and some wrist function May be able to propel a wheelchair inside on smooth surfaces; may be able to help feed, groom, and dress self; dependent on others for transfers
C7 Quadripapresis with shoulder, elbow, wrist, and some hand function May be able to propel a wheelchair outside, transfer self, and drive a car with special adaptions; may be able to help with bowel and bladder programs
C8 Quadripapresis with normal arm function; hand weakness May be able to propel a wheelchair outside, transfer self, and drive a car with special adaptions; may be able to help with bowel and bladder programs
T1 – T6 Paraplegia with loss of function below mid-chest; full control of arms Independent with self care and in wheelchair; able to be employed full time
T6 – T12 Paraplegia with loss of function below the waist; good control of torso Good sitting balance; greater ability for operation of a wheelchair and athletic activities
L1 – L5 Paraparesis with varying degrees of muscle involvement in the legs May be able to walk short distances with braces and assistive devices
Tags: