Areas of Practice: Spinal Cord Injury
Over 10,000 people in the US suffer a spinal cord injury, also called SCI, each year. SCI is defined as any damage to the spinal cord that results in loss of function or mobility. Such injuries can be caused by trauma or disease and can result in temporary or permanent loss of sensation, loss of movement (paralysis), or loss of bowel or bladder control. Auto accidents are the primary cause but violence related accidents have been increasing steadily as a cause of SCI’s. Falls and sports accidents also cause many SCI’s each year.
There are two types of injury, complete and incomplete. A complete injury is one in which the victim has no sensation or voluntary motor movement on either side of the body below the level of the injury. If the victim has some feeling or partial movement, it is called an incomplete injury.
Injuries are usually defined with reference to the area of the spine affected. Nerves in the spine are defined by the area of the vertebrae – an injury to the spine in the neck area will affect the cervical vertebrae – injury to the nerves at the fifth cervical vertebra is called a C-5 injury, for instance. Below the neck are the thoracic vertebrae, so injuries there are defined as T-1, etc. Then there are lumbar and sacral vertebrae.
Generally speaking, neck injuries will lead to paralysis of all limbs (quadriplegia) while thoracic injuries cause paralysis to the lower limbs only (paraplegia). Both areas have variations in the amount of dysfunction, depending on the severity of the injury. An incomplete cervical injury can leave the patient with some hand use, while a complete injury at C-4 can require the patient to be on a ventilator. Thoracic injuries can leave the arms functional but interfere with walking, bowel and bladder control, and sexual function. Other functions that can be affected are blood pressure, body temperature, and pain levels.
A spinal cord injury usually involves swelling of the spinal cord which affects the whole body. When the swelling goes down, the patient may regain function months or years after the injury but it is rare for all functioning to be recovered. Treatment presently consists of stabilizing any broken vertebrae, maintaining the patient, preventing movement to the injured area, and reducing swelling. There is no cure for SCI but stem cell research has shown some signs of being useful in the future