What is Spinal Cord Injury?

A spinal cord injury usually begins with a sudden, traumatic blow to the spine that
fractures or dislocates vertebrae. The damage begins at the moment of injury when
displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord
tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is
more likely to cause fractures and compression of the vertebrae, which then crush and
destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord
between the brain and the rest of the body. An injury to the spinal cord can damage a few,
many, or almost all of these axons. Some injuries will allow almost complete recovery.
Others will result in complete paralysis.

Is there any treatment?

Improved emergency care for people with spinal cord injuries and aggressive treatment
and rehabilitation can minimize damage to the nervous system and even restore limited
abilities. Respiratory complications are often an indication of the severity of spinal cord
injury About one-third of those with injury to the neck area will need help with
breathing and require respiratory support. The steroid drug methylprednisolone appears to
reduce the damage to nerve cells if it is given within the first 8 hours after injury.
Rehabilitation programs combine physical therapies with skill-building activities and
counseling to provide social and emotional support.

What is the prognosis?

Spinal cord injuries are classified as either complete or incomplete. An incomplete injury
means that the ability of the spinal cord to convey messages to or from the brain is not
completely lost. People with incomplete injuries retain some motor or sensory function
below the injury. A complete injury is indicated by a total lack of sensory and motor
function below the level of 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.
Successful recovery depends upon how well these chronic conditions are handled day to
day.

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) conducts spinal
cord research in its laboratories at the National Institutes of Health (NIH) and also
supports additional research through grants to major medical institutions across the
country. Advances in research are giving doctors and patients hope that repairing injured
spinal cords is a reachable goal. Advances in basic research are also being matched by
progress in clinical research, especially in understanding the kinds of physical
rehabilitation that work best to restore function. Some of the more promising
rehabilitation techniques are helping spinal cord injury patients become more mobile.

http://www.ninds.nih.gov/disorders/sci/sci.htm

What is Spinal Cord Injury? Spinal Cord Injury (SCI) is damage to the
spinal cord that results in a loss of function such as mobility or feeling. Frequent
causes of damage are trauma (car accident, gunshot, falls, etc.) or disease (polio, spina bifida,
Friedreich's Ataxia, etc.). The spinal cord does not have to be severed in order for a loss of
functioning to occur. In fact, in most people with SCI, the spinal cord is intact, but the damage to
it results in loss of functioning. SCI 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.
What is the spinal cord and the vertebra? 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,
and another diffuse system of nerves that control involuntary functions such as blood pressure
and temperature regulation are 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 SCI's usually cause loss of function in the arms and legs, resulting in
quadriplegia. The twelve 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 and result 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 functioning in the hips and legs.
 What are the effects of SCI? The effects of SCI depend on the type of
injury and the level of the injury. SCI can be divided into two types of injury -
complete and incomplete. A complete injury means that 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 that there is
some functioning below the primary level of the 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 SCI,
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 as the result of lack of
abdominal muscle control. Lower T-injuries (T-9 to T-12) allow good truck 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 functioning, individuals with SCI also experience other
changes. For example, they may experience dysfunction of the bowel and bladder,. Sexual
functioning is frequently with SCI may have their fertility affected, while women's fertility is
generally not affected. 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 SCI 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
How many people have SCI? Who are they? Approximately 450,000 people live with SCI
in the US. There are about 10,000 new SCI's every year; the majority of them (82%) involve
males between the ages of 16-30. These injuries result from motor vehicle accidents (36%),
violence (28.9%), or falls (21.2%).Quadriplegia is slightly more common than paraplegia. Is
there a cure?
Currently there is no cure for SCI. There are researchers attacking this problem, and there have
been many advances in the lab (see research updates ). 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. The experimental drug SygenÆappears to reduce loss of function, although the
mechanism is not completely understood.

Do people with SCI ever get better?

When a SCI 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 injuries, the
individual may recover some functioning as late as 18 months after the injury. In very rare cases,
people with SCI will regain some functioning years after the injury. However, only a very small
fraction of individuals sustaining SCIs recover all functioning.

Does everyone who sustains SCI use a wheelchair?

No. Wheelchairs are a tool for mobility. High C-level injuries usually require that the
individual 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 powerchair, the
independence afforded by them is worth the limitations. Some people are able to use braces and
crutches for ambulation. These methods of mobility do not mean that 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. No one is "wheelchair bound."

Do people with SCI die sooner?

Yes. Before World War II, most people who sustained SCI died within weeks of their injury
due to 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. Interestingly, other than level of injury, the type of rehab facility used is the greatest
indicator of long-term survival. This illustrates the importance of and the difference made by
going to a facility that specializes in SCI. People who use vents are at some increased danger of
dying from pneumonia or respiratory infection, but modern technology is improving in that area
as well. Pressure sores (learn more about pressure soars here) are another common cause of
hospitalization, and if not treated - death.
Overall, 85% of SCI patients 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 persons with quadriplegia.
The second leading cause of death is non-ischemic heart disease. These are almost always
unexplained heart attacks often occurring among young persons who have no previous history of
underlying heart disease.
Deaths due to external causes is the third leading cause of death for SCI patients. These include
subsequent unintentional injuries, suicides and homicides, but do not include persons dying from
multiple injuries sustained during the original accident. The majority of these deaths are the
result of suicide.

Do people with SCI have jobs?

 People with SCI have the same desires as other people. That includes a desire to work and be
productive. The Americans with Disabilities Act (ADA) promotes the inclusion of people with
SCI to mainstreamin day-to-day society. Of course, people with disabilities may need some
changes to make their workplace more accessible, but surveys indicate that the cost of making
accommodations to the workplace in 70% of cases is $500 or less.

Choosing a rehabilitation center is very important. Not all rehabilitation centers have a spinal
cord injury program. Do as much research as possible, don't be afraid to ask questions. Since
each individuals needs will vary, with the help of the NSCIA, I have put together some questions
and information to help get you started, but keep in mind its just a reference to help get you
started.

A good rehabilitation center does not necessarily need to adhere to all of these guidelines. Feel
free to print this page out and take it with you on your visit, or keep it handy when you make
your phone inquiries.

I have also started to put a list of rehabilitation centers across the nation specializing in the care
and needs of spinal cord injuries. Along with locations and contact information.

• Here is a list of 18 model spinal cord injury centers

• Department of veterans affairs: spinal cord injury centers
• Discuss rehabilitation or post your questions on our community message boards

Some questions to consider when inquiring about a rehabilitation center

• Are the beds for people with SCI in the same area of the facility? Are there people in the
SCI program of the same age and sex as the person considering admission?
• Do the people in the SCI program have similar levels and kinds of spinal cord injury e.g.,
quadriplegia, paraplegia, incomplete and complete?
• What is the average number of people admitted annually to the SCI program? (program
staff should treat people with SCI on a regular basis to acquire and maintain expertise.)
• Is the SCI program accredited by the Commission on the Accreditation of Rehabilitation
Facilities (CARF) or the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO)? Has it been designated as a Model Spinal Cord Injury Center by the National
Institute of Disability Research and Rehabilitation (NIDRR)? Click here for a current list
of Model spinal cord injury centers)
• Is the SCI program part of a SCI rehabilitation system operated by the state?
• Are there treatment specialists in the SCI program who speak the primary language of the
individual seeking treatment?
• Will the treatment team develop a rehabilitation plan with both short and long term
goals?
• Will an experienced case manager be assigned to help family members obtain medical
payments and other benefits from public and private insurance? Will a team member be
assigned to coordinate treatment and act as a contact for staff and family members?
 Staffing/Rehabilitation Program Elements

• Is the physician in charge a Physiatrist? If not, what credentials does he/she have? How
long has the physician in charge been directing programs specializing in SCI? Is there
physician coverage seven days a week? Twenty-four hours a day?
• Do the regular nursing staff and other specialists responsible for providing treatment in
the SCI program have specific training in treating SCI? Is the nursing staff employed by
the hospital or employed through an outside agency?
• Does the program ensure the availability of rehabilitation nursing and respiratory care on
a twenty-four hour basis?
• Are there consultants available at the facility or nearby medical centers? These should
include neurosurgery, neurology, urology, orthopedics, plastic surgery, neuropsychology,
internal medicine, gynecology, speech pathology, pulmonary medicine, general surgery
and psychiatry.
• How often and for how long each day will participants get treatment by specialists such
as occupational and physical therapists? Treatment should be no less then three hours per
day.
• Are other specialties such as driver education, rehabilitation engineering, chaplaincy, and
therapeutic recreation available if needed?
• Are activities planned for SCI program participants on weekends and evenings?
• How much time is spent teaching SCI program participants and their families about
sexuality, bowel and bladder care, skin care and other essential self-care activities?
• Does the SCI program offer training in the management and hiring of personal care
assistants? If so, how much time is spent by staff on this topic?

SPECIAL PROGRAMS

Pediatric Programs

• Because incidence rates of SCI among children are relatively low, rehabilitation hospitals
and programs usually do not maintain a separate program or unit exclusively for children
with SCI. As an alternative, caregivers may consider facilities/programs which place
children with SCI in rehabilitation units with other children with chronic disabilities.
Hopefully, this will provide families and children with opportunities to share common
experiences and information with each other, and may lead to the development of support
networks in the community.
• It is possible that children may be placed in units with other children who are too ill for
rehabilitation. Children generally derive greater benefit if they undergo rehabilitation
with other children who are actively involved in the rehabilitation process.
• Are the beds for children with spinal cord injuries in one area or in the same location as
children with similar disabilities?
• Are children of the same sex and similar age currently in the program/facility?
• Is the physician in charge an individual with experience in rehabilitation? Does this
physician have experience with children? If not, what are his/her qualifications? Do the
other staff members specialize in pediatrics?
• How many children with SCI does the program/facility admit on an annual basis?
• Does the program/facility offer educational programs for children and young adults
undergoing treatment? If not, does the facility coordinate tutoring programs with local
schools? If so, who is responsible for payment?
• Are there child life or therapeutic recreation specialists on staff? (Child life specialists
develop programs for children and families which strive to maintain normal living
patterns and minimize the clinical environment. Therapeutic recreation specialists focus
on teaching persons with disabilities new leisure and sports skills to maximize their
independence).
• Are young siblings and friends allowed to visit the unit?
• Does the program/facility offer adaptive technology to help children communicate and
learn?
• Is counseling available for siblings and families members?
• Is the equipment used by therapists, appropriate for children?
• Does the facility/program provide patient education materials for children and family
members?

Ventilator Programs

• Is the physician who directs the program a board certified Pulmonologist or a Physiatrist?
Does he/she have experience with SCI? Are ventilator users treated on the same unit?
• How long has the facility been providing treatment for ventilator users?
• If the treatment team determines that an individual cannot breathe independently, what
kind of services are offered to assist them in living as independently as possible?
• Are people in the unit similar in age to the person considering admission?
• Will they have the opportunity to meet ventilator users who have returned to the
community and maximized their independence?

Special Considerations

Psycho social/Counseling Services

• What types and how many hours of psycho social services are available? These should
include peer support, individual and group psychotherapy, couples, vocational and
substance abuse counseling? Does the facility offer sexuality and fertility counseling?

Facility Policies/Family Members

• Do facility policies encourage family members including siblings regardless of age, to

participate in rehabilitation programs? Are there living arrangements for family members
participating in training? What other services, parking, meals and etc. are provided? Are
counseling and other social services available to family members?

Discharge Planning

• Are SCI program participants given educational self-care manuals when they are
 discharged?
• Will staff members develop a formal discharge plan with program participants and their
families?
• Does the facility and discharge planner work with local Independent Living Centers? Do
they incorporate referrals to these centers into their discharge planning? Is there an
independent living unit available for program participants and families to practice self-
care skills? Can family members stay there also?
• If the facility does not have an independent living unit do they encourage overnight
therapeutic leave prior to discharge?
• Will someone be assigned as a liaison to provide follow-up services? Will a staff member
visit or make arrangements for someone locally to evaluate the home for modifications?
• Will the follow-up plan include:
• Referral to an appropriate physician and other medical specialists in the community?
• Regular follow-up visits with this physician or a spinal cord injury unit physician?
• Regular urological evaluations?
• Scheduled equipment evaluations?
• If appropriate, a thorough vocational evaluation and referrals to a vocational
rehabilitation program?

http://www.spinalinjury.net/html/_finding_a_rehab.html

Definition
In 1995, actor Christopher Reeve fell off a horse and severely damaged his spinal cord,
leaving him paralyzed from the neck down. From then until his death in 2004, the silver
screen Superman became the most famous face of spinal cord injury.

Most spinal cord injury causes permanent disability or loss of movement (paralysis) and
sensation below the site of the injury. Paralysis that involves the majority of the body,
including the arms and legs, is called quadriplegia or tetraplegia. When a spinal cord
injury affects only the lower body, the condition is called paraplegia.

Christopher Reeve's celebrity and advocacy raised national interest, awareness and
research funding for spinal cord injury. Many scientists are optimistic that important
advances will occur to make the repair of injured spinal cords a reachable goal. In the
meantime, treatments and rehabilitation allow many people with spinal cord injury to
lead productive, independent lives.

Symptoms
CLICK TO ENLARGE
Spinal cord injuries

Spinal cord injury symptoms depend on two factors:

• The location of the injury. In general, injuries that are higher in your spinal cord
produce more paralysis. For example, a spinal cord injury at the neck level may
cause paralysis in both arms and legs and make it impossible to breathe without a
respirator, while a lower injury may affect only your legs and lower parts of your
body.
• The severity of the injury. Spinal cord injuries are classified as partial or
complete, depending on how much of the cord width is damaged.

In a partial spinal cord injury, which may also be called an incomplete injury,
the spinal cord is able to convey some messages to or from your brain. So people
with partial spinal cord injury retain some sensation and possibly some motor
function below the affected area.

A complete spinal cord injury is defined by total or near-total loss of motor

function and sensation below the area of injury. However, even in a complete
injury, the spinal cord is almost never completely cut in half. Doctors use the term
"complete" to describe a large amount of damage to the spinal cord. It's a key
distinction because many people with partial spinal cord injuries are able to
experience significant recovery, while those with complete injuries are not.

Spinal cord injuries of any kind may result in one or more of the following signs and
symptoms:

• Pain or an intense stinging sensation caused by damage to the nerve fibers in your
spinal cord
• Loss of movement
• Loss of sensation, including the ability to feel heat, cold and touch
• Loss of bowel or bladder control
• Exaggerated reflex activities or spasms
• Changes in sexual function, sexual sensitivity and fertility
• Difficulty breathing, coughing or clearing secretions from your lungs

Emergency signs and symptoms

Emergency signs and symptoms of spinal cord injury after a head injury or accident may
include:

• Fading in and out of consciousness

• Extreme back pain or pressure in your neck, head or back
 • Weakness, incoordination or paralysis in any part of your body
• Numbness, tingling or loss of sensation in your hands, fingers, feet or toes
• Loss of bladder or bowel control
• Difficulty with balance and walking
• Impaired breathing after injury
• An oddly positioned or twisted neck or back

Causes
Your brain and central nervous system
Together, your spinal cord and your brain make up your central nervous system, which
controls most of the functions of your body. Your spinal cord runs approximately 15 to 17
inches from the base of your brain to your waist and is composed of long nerve fibers that
carry messages to and from your brain.

These nerve fibers feed into nerve roots that emerge between your vertebrae — the 33
bones that surround your spinal cord and make up your backbone. There, the nerve fibers
organize into peripheral nerves that extend to the rest of your body.

Injury may be traumatic or nontraumatic

A traumatic spinal cord injury may stem from a sudden, traumatic blow to your spine that
fractures, dislocates, crushes or compresses one or more of your vertebrae. It may also
result from a gunshot or knife wound that penetrates and cuts your spinal cord. Additional
damage usually occurs over days or weeks because of bleeding, swelling, inflammation
and fluid accumulation in and around your spinal cord.

Nontraumatic spinal cord injury may be caused by arthritis, cancer, blood vessel
problems or bleeding, inflammation or infections, or disk degeneration of the spine.

Damage to nerve fibers

Whether the cause is traumatic or nontraumatic, the damage affects the nerve fibers
passing through the injured area and may impair part or all of your corresponding
muscles and nerves below the injury site. Spinal injuries occur most frequently in the
neck (cervical) and lower back (thoracic and lumbar) areas. A thoracic or lumbar injury
can affect leg, bowel and bladder control, and sexual function. A cervical injury may
affect breathing as well as movements of your upper and lower limbs.

The spinal cord ends at the lower border of the first vertebra in your lower back —
known as a lumbar vertebra. So injuries below this vertebra actually don't involve the
spinal cord. However, an injury to this part of your back or pelvis may damage nerve
roots in the area and may cause some loss of function in the legs, as well as difficulty
with bowel and bladder control and sexual function.

Common causes of spinal cord injury

The most common causes of spinal cord injury in the United States are:
 • Motor vehicle accidents. Auto and motorcycle accidents are the leading cause of
spinal cord injuries, accounting for almost 50 percent of new spinal cord injuries
each year.
• Acts of violence. About 15 percent of spinal cord injuries result from violent
encounters, often involving gunshot and knife wounds.
• Falls. Spinal cord injury after age 65 is most often caused by a fall. Overall, falls
make up approximately 22 percent of spinal cord injuries.
• Sports and recreation injuries. Athletic activities such as impact sports and
diving in shallow water cause about 8 percent of spinal cord injuries.
• Diseases. Cancer, infections, arthritis and inflammation of the spinal cord also
cause spinal cord injuries each year.

Treatments and drugs

Fifty years ago, a spinal cord injury was usually fatal. At that time, most injuries were
severe, complete injuries and little treatment was available.

Today, there's still no way to reverse damage to the spinal cord. But modern injuries are
usually less severe, partial spinal cord injuries. And advances in recent years have
improved the recovery of people with a spinal cord injury and significantly reduced the
amount of time survivors must spend in the hospital. Researchers are working on new
treatments, including innovative treatments, prostheses and medications that may
promote nerve cell regeneration or improve the function of the nerves that remain after a
spinal cord injury.

In the meantime, spinal cord injury treatment focuses on preventing further injury and
enabling people with a spinal cord injury to return to an active and productive life within
the limits of their disability. This requires urgent emergency attention and ongoing care.

Emergency actions
Urgent medical attention is critical to minimizing the long-term effects of any head or
neck trauma. So treatment for a spinal cord injury often begins at the scene of the
accident.

If you suffer a head or neck injury, you'll likely be treated by paramedics and emergency
workers who will attend to three immediate concerns:

• Maintaining your ability to breathe

• Keeping you from going into shock
• Immobilizing your neck to prevent further spinal cord damage

Emergency personnel typically immobilize the spine as gently and quickly as possible
using a rigid neck collar and a rigid carrying board, which they'll use to transport you to
the hospital.
In the emergency room, doctors focus on maintaining your blood pressure, breathing and
neck stabilization and avoiding possible complications, such as stool or urine retention,
respiratory or cardiovascular difficulty, and formation of deep vein blood clots in the
extremities. You may be sedated so that you don't move and sustain more damage while
undergoing diagnostic tests for spinal cord injury.

If you do have a spinal cord injury, you'll usually be admitted to the intensive care unit
for treatment. You may even be transferred to a regional spine injury center that has a
team of neurosurgeons, orthopedic surgeons, spinal cord medicine specialists,
psychologists, nurses, therapists and social workers with expertise in spinal cord injury.

Early stages of treatment

In the early stages of paraplegia or quadriplegia, your doctor will treat the injury or
disease that caused the loss of function. Immediate treatment may include:

• Medications. Methylprednisolone (Medrol) is a treatment option for acute spinal

cord injury. This corticosteroid seems to cause some recovery in people with a
spinal cord injury if given within eight hours of injury. Methylprednisolone works
by reducing damage to nerve cells and decreasing inflammation near the site of
injury.
• Immobilization. You may need traction to stabilize your spine and bring the spine
into proper alignment during healing. Sometimes, traction is accomplished by
placing metal braces, attached to weights or a body harness, into your skull to
hold it in place. In some cases, a rigid neck collar also may work.
• Surgery. Often, emergency surgery is necessary to remove fragments of bones,
foreign objects, herniated disks or fractured vertebrae that appear to be
compressing the spine. Surgery may also be needed to stabilize the spine to
prevent future pain or deformity. Controversy exists regarding the best time to
perform surgery. Some surgeons believe it should be performed as soon as
possible in most circumstances, while others believe it's safer to wait for several
days before attempting any surgery. Research has not clearly proved which
approach is better.

Ongoing care
After the initial injury or disease stabilizes, doctors turn their attention to problems that
may arise from immobilization, such as deconditioning, muscle contractures, bedsores,
urinary infection and blood clots. Early care will likely include range-of-motion exercises
for paralyzed limbs, help with your bladder and bowel functions, applications of skin
lotion, and use of soft bed coverings or flotation mattresses, as well as frequently
changing your position.

Hospitalization can last from several days to several weeks, depending on the cause and
extent of the paralysis and the progress of your therapy. But treatment doesn't stop when
you check out of the hospital.

Here are some of the ongoing treatments you can expect.

Rehabilitation. During your hospital stay, a rehabilitation team will work with you to
improve your remaining muscle strength and to give you the greatest possible mobility
and independence. Your team may include a physical therapist, occupational therapist,
rehabilitation nurse, rehabilitation psychologist, social worker, dietitian recreation
therapist and a doctor who specializes in physical medicine (physiatrist) or spinal cord
injury.

During the initial stages of rehabilitation, therapists usually emphasize regaining leg and
arm strength, redeveloping fine-motor skills and learning adaptive techniques to
accomplish day-to-day tasks. A program typically includes exercise, as well as training on
the medical devices you'll need to assist you, such as a wheelchair or equipment that can
make it easier to fasten buttons or dial a telephone.

Therapy often begins in the hospital and continues in a rehabilitation facility. As therapy
continues, you and your family members will receive counseling and assistance on a wide
range of topics, from dealing with urinary tract infections and skin care to modifying
your home and car to accommodate your disability. Therapists will encourage you to
resume your favorite hobbies, participate in athletic activities and return to the workplace,
if possible. They'll even help determine what type of assistive equipment you'll need for
these vocational and recreational activities and teach you how to use it.

Medications. You may benefit from medications that manage the signs, symptoms and
complications of spinal cord injury. These include medications to control pain and muscle
spasticity, as well as medications that can improve bladder control, bowel control and
sexual functioning. You may also need short-term medications from time to time, such as
antibiotics for urinary tract infections.

New technologies. Inventive medical devices can help people with a spinal cord injury
become more independent and more mobile. Some apparatuses may also restore function.
These include:

• Modern wheelchairs. Improved, lighter weight wheelchairs are making people

with spinal cord injury more mobile and more comfortable. Some wheelchairs can
even climb stairs, travel over rough terrain and elevate a seated passenger to eye
level to reach high places without help.
• Computer devices. Computer-driven tools and gadgets can help with daily
routines. You can use voice-activated computer technologies to answer and dial a
phone, or to use a computer and pay bills. Computer-controlled technologies can
also help with bathing, dressing, grooming, cleaning and reading.
• Electrical stimulation devices and neural prostheses. These sophisticated
devices use electrical stimulation to produce actions. Some are implanted under
the skin and connect with the nervous system to supplement or replace lost motor
and sensory functions. Others are outside the body. They are often called
functional electrical stimulation (FES) systems, and they use electrical stimulators
to control arm and leg muscles to allow people with a spinal cord injury to stand,
walk, reach and grip.
These systems are composed of computer-controlled electrodes that are taped to the skin
or implanted under the skin and controlled by the user. One of the systems allows
someone with a spinal cord injury to trigger hand and arm movements. These devices
require more research, but they've gained a great deal of attention, in part because the
actor Christopher Reeve was able to rely primarily on an FES bicycle that used computer-
controlled electrodes to stimulate his legs to cycle. He also had a system implanted to
stimulate his breathing.

Prognosis and recovery

It's often impossible for your doctor to make a precise prognosis right away. Recovery, if
it occurs, typically starts between a week and six months after injury. Impairment
remaining after 12 to 24 months is likely to be permanent.

However, some people experience small improvements for up to two years or longer. At
one point, Christopher Reeve made national headlines when he regained the ability to
move his fingers and wrists and feel sensations more than five years after he was
paralyzed in a horse accident. But many not-so-famous folks with a spinal cord injury
have made similar strides away from the media spotlight. And doctors are researching
ways to improve late recovery.

Prevention
Following this advice may reduce your risk of a spinal cord injury:

• Drive safely. Motor vehicle accidents are the leading cause of spinal cord injuries.
Wear a seat belt every time you drive. Make sure that your children wear a seat
belt or, if they're very young, use an age- and weight-appropriate child safety seat.
Children under age 12 should always ride in the back seat to avoid air bag
injuries. Don't drive while intoxicated.
• Be safe with firearms. Lock up firearms and ammunition in a safe place to
prevent accidental discharge of weapons. Store guns and ammunition separately.
• Prevent falls. Use a stool or stepladder to reach objects in high places. Add
handrails along stairways. Place nonslip mats on your bathroom and shower floor.
For young children, use safety gates to block stairs and consider installing
window guards.
• Take precautions when playing sports. Always wear recommended safety gear.
Avoid headfirst moves, such as diving into shallow water, spear tackling in
football, sliding headfirst in baseball and skating headfirst into the boards in ice
hockey. Use a spotter in gymnastics.

Spinal cord injury

ARTICLE SECTIONS
• Definition • Tests and diagnosis
• Symptoms • Complications
 • Causes • Treatments and drugs
• Risk factors • Prevention

• When to seek medical • Coping and support

advice

Coping and support

An accident that results in paralysis is a life-changing event. The sudden presence of
disability can be frightening and confusing. You may wonder how spinal cord injury will
affect your everyday activities, job, relationships and long-term happiness.

Recovery from such an event takes time, but many people who are paralyzed move on to
lead productive and fulfilling lives. The will to live in humans is amazingly strong, and
the creativity with which many affected people lead their lives is great. It's essential to
stay motivated and get the support you need.

Grieving
If you're newly injured, you and your family will likely experience a period of mourning
and grief that's similar to the period after the death of a loved one. Although the grieving
process is different for everyone, it's common to experience denial or disbelief, then
sadness, anger, bargaining, and, finally, acceptance.

The grieving process is a common, healthy part of your recovery. It's natural — and
important — to grieve the loss of the way you were. But it's also necessary to set new
goals and find a way to move forward with your life.

Taking control
One of the best ways to regain control of your life is to educate yourself about your injury
and your options for reclaiming an independent life. A wide range of driving equipment
and vehicle modifications is available today. The same is true of home modification
products. Ramps, wider doors, special sinks, grab bars and easy-to-turn doorknobs make
it possible for you to assert your autonomy.

Because the costs of a spinal cord injury can be overwhelming, you may want to find out
if you are eligible for economic assistance or support services from the state or federal
government or from charitable organizations. Your rehabilitation team can help you
identify resources in your area.

Talking about your disability

Your friends and family may respond to your disability in different ways. Some may be
unfazed by your injury. Others may be uncomfortable and unsure if they are saying or
doing the right thing. And some may have a difficult time adjusting to the change. They
may grieve for the loss of the way your life was before the accident. They may be scared
about the financial challenges and stress that are sure to arise. Or they may be nervous
about their new role as caregiver.
Educating people about your disability is often the best solution. Children are naturally
curious and sometimes adjust rather quickly if their questions are answered in a clear,
straightforward way. Adults can also benefit from learning the facts. Explain the effects
of your injury and what your family and friends can do to help. At the same time, don't
hesitate to tell friends and loved ones when they're helping too much. Although it may be
uncomfortable at first, talking about your injury often strengthens your relationships with
family and friends.

Dealing with intimacy

Many men and women with a spinal cord injury wonder if they can maintain a romantic,
intimate relationship with a partner. The answer is yes.

However, people with a spinal cord injury often need to address physical and emotional
changes that can affect sexuality. You may need medical treatments or medications to
have sexual intercourse. In some cases, intercourse may not be possible and you and your
partner may need to explore and experiment with different ways to be romantic and
intimate. A professional counselor can help you and your partner communicate your
needs and feelings so that you're more comfortable talking about sex and discovering
what is fulfilling for both of you.

Taking care of yourself

As you adjust to your disability, allow yourself time to rest and time to process your
thoughts and feelings about your disability. This is also a good time to concentrate on
eating a healthy diet and reducing stress.

Good nutrition will help you build enough strength to fully participate in daily activities.
A balanced diet will also help you fight infections and maintain proper body weight. Plus,
it will help maintain regular bladder and bowel functioning and assist in preventing
pressure ulcers.

Looking ahead
By nature, a spinal cord injury has a sudden impact on your life and the lives of those
closest to you. When you first hear your diagnosis, you may start making a mental list of
all of the things you can't do anymore. However, as you learn more about your injury and
your treatment options, you may be surprised at all of the things you can do.

Thanks to new technologies, treatments and devices, people with a spinal cord injury play
basketball and participate in track meets. They paint and take photographs. They get
married, raise children and have rewarding jobs.

Today, advances in stem cell research and nerve cell regeneration give hope for a greater
recovery for people with a spinal cord injury. Several experimental treatments are being
tested around the world. At the same time, new medications are being developed for
people with long-standing spinal cord injuries. No one knows exactly when new
treatments will become available, but you can remain hopeful about the future of spinal
cord research, while living your life to the fullest today.
http://www.mayoclinic.com/health/spinal-cord-injury/DS00460/DSECTION=coping-
and-support

Spinal Cord Injury : Quadriplegic and Paraplegic Injuries

Paraplegic and Quadriplegic (Tetraplegic) are terms used to describe the
medical condition, for a person who has been paralysed due to a spinal
cord injury. This classification depends on the level and severity of a
persons paralysis, and how it affects their limbs.

This website provides Patient Information about acute spinal cord

injuries, as well as treatment, symptoms, information on long term
rehabilitation issues and Peer Support, to help improve the quality of
life of those affected by a spinal cord injury.

What is a Spinal Cord Injury ?

A Spinal Cord Injury (SCI) is typically defined as damage or trauma to
the spinal cord that in turn results in a loss or impaired function
resulting in reduced mobility or feeling.

Typical common causes of damage to the spinal cord, are trauma

(car/motorcycle accident, gunshot, falls, sports injuries, etc), or disease
(Transverse Myelitis, Polio, Spina Bifida, Friedreich's Ataxia, etc.). The
resulting damage to the spinal cord is known as a lesion, and the
paralysis is known as Quadriplegia or Quadraplegia / Tetraplegia if the
injury is in the Cervical (neck) region, or as Paraplegia if the injury is in
the Thoracic, Lumbar or Sacral region.

It is possible for someone to suffer a Broken Neck,or a Broken Back

without becoming paralysed. This occurs when there is a fracture or
dislocation of the vertebrae, but the spinal cord has not been damaged.

What is a Complete and Incomplete Spinal Cord Injury

There are typically two types of lesions associated with a spinal cord
injury, these are known as a complete spinal cord injury and an
incomplete spinal cord injury. A complete type of injury means the person
is completely paralysed below their lesion. Whereas an incomplete
injury, means only part of the spinal cord is damaged. A person with an
incomplete injury may have sensation below their lesion but no
movement, or visa versa. There are many types in incomplete spinal
cord injuries, and no two are the same.

Such injuries are known as Brown Sequard Syndrome, Central Cord

Syndrome, Anterior Cord Syndrome and Posterior Cord Syndrome.

What is Spinal Cord Injury Rehabilitation

Someone with a spinal cord injury will have a long road of
rehabilitation ahead of them, usually at a Spinal Cord Injury Treatment
Unit and Rehabilitation Centre or Spinal Injury Unit, and it is important
that they keep their sense of humor on their bad days to help them
maintain a positive attitude.

Generally, Paraplegics will be in hospital for around 5 months, where as

Quadriplegics can be in hospital for around 6 - 8 months, whilst they
undergo rehabilitation. Both Paraplegics and Quadriplegics should have
some kind of rehabilitation and physiotherapy before they are
discharged from hospital, to help maximise their potential, or help them
get used to life in a wheelchair, and to help teach techniques which make
everyday life easier.

Disabled sports, and wheelchair based sports can be an excellent way to

build stamina, and help in rehabilitation by giving confidence and better
social skills. The ultimate reward for many disabled sportsmen and
women, is to win at the Paralympic Games, which will be coming to
London in 2012.

Spinal Cord Injury Cure and Treatment

A cure for long term paralysis is still some years in the future, but
clinical trials are taking place with Olfactory Ensheathing Glial (OEG)
cells and Embryonic Stem Cell based Therapy.

Paraplegic and Quadriplegic Discussion Forum

If you have any spinal cord injury related questions, please visit our
Discussion Forums and join in on the many topics there. We will do our
best to help you, or at the very least, put you in contact with someone
who can if we can't. The discussion forum is intended to be a free flow of
information between spinally injured people, carers, and their friends,
and everyone is welcome.

Even if you don't have any questions, take a look at the forum anyway,
as you may be able offer help and advice to others who have questions.
More >>>

Quadriplegic, Tetraplegic, Paraplegic and What it

Means
Quadraplegic is derived from two separate words from two different
languages, Latin and Greek. The word “Quadra”, meaning “four”
which is derived from latin, relates to the number of limbs. “Plegic”, is
derived from the Greek word “Plegia”, meaning paralysis.

Put the two together, and you have “Quadraplegia”.

“Tetra” is derived from the Greek word for “Four”. “Para” is derived
from the Greek word for "two" Hence: Tetraplegic and Paraplegic.

In Europe, the term for 4 limb paralysis has always been tetraplegia.
The Europeans would never dream of combining a Latin and Greek
root in one word.

In 1991, when the American Spinal Cord Injury Classification system

was being revised, the difference in names was discussed. The British
are more aware of Greek versus Latin names. Since Plegia is a greek
word and quadri is Latin, the term quadriplegia mixes language
sources. Upon review of the literature, it was recommended that the
term tetraplegia be used by the American Spinal Cord Association so
that there are not two different words in English referring to the same
thing.
http://www.apparelyzed.com/