Spinal Cord Injury (often abbreviated to SCI) can result from damage to the spinal cord itself or from damage to the vertebrae and surrounding tissue. SCI can result from damage to the cauda equina which are the nerves and roots typically at L1-L5.
The effect on the person injured will depend upon where on the spine the injury occurs.
Spinal injuries are often referred to as complete or incomplete spinal cord injuries.
A complete spinal cord injury results in a complete lack of movement or feeling below the site at which the cord has been damaged, severing the link between the brain and nervous system. The higher up the injury occurs, the more severe the damage and loss of function and feeling results. High-level injuries result in an inability to cough or breathe independently.
Incomplete spinal cord damage results in limited messages being able to be sent to and from the brain and as a result, some function and feelings remain from below the injury site.
A traumatic injury describes a sudden and violent blow to the spine that fractures or dislocates or compresses the vertebrae. Typical causes of such injuries include road traffic collisions or falls from height.
Non-traumatic injuries which account for approximately 2% of all spinal cord injuries and are not caused by direct trauma, but instead result from developmental abnormalities such as spina bifida, or disease such as cancer, inflammation, infections, or disk degeneration of the spine.
The life expectancy for someone with a spinal cord injury can be either a normal life span or slightly shortened and there is a strong correlation between life expectancy, and level of neurological impairment and the level of care given. Death is normally not the result of the actual damage to the spinal cord, but by secondary complications such as diseases, infections, or accidents that result from the body’s compromised abilities. Spinal cord injuries affect the body in many systems other than motor skills.
The loss of sensation will result usually in a loss of function. The sensation from brain to body travels to and from the body via sensory receptors via the spinal cord to the brain where we become aware of a stimulus and generate responses and this is referred to as the Central Nervous system. A disruption of the pathway results in the brain not receiving the correct message from the body. Sensory input and the initiation of motion occur continuously, so whenever the scenario you may be aware of, say an itch or an object in your skin, your body will initiate a response even if it’s just a reflex. Failure to recognize or respond to stimuli can result in various problems such as pressure sores, limitation of muscle and joint activities. If there is no motor/sensory function below the level of injury, it is described as complete loss of function. This can result in chest infection or not being able to clear secretions from the chest.
Spinal cord injury symptoms can affect sensory, motor or autonomic symptoms and are caused by damage to the vertebrae, ligaments, or disks of the spinal column or to the spinal cord itself. The majority of spinal cord injuries are caused by trauma. In the UK, almost half of SCI’s caused each year are caused by road traffic collisions or accidents, most often as a driver or passenger of a car or as a motorcyclist.
Industrial accidents ie accidents at work, especially those associated with construction and heights, account for 1 in 5 of all spinal cord injuries. Falls are the cause of over a third of spinal cord injuries and are the leading cause of injury over the age of 45.
Recreational or sports are responsible for approximately 10% of spinal cord injuries and can be caused by acute trauma (e.g., impact from a football tackle) or gradual damage (e.g., repetitive motion in golf or rowing).
Violence (especially involving knife and gunshot wounds) are also known to cause spinal cord injuries.
Spinal cord damage currently cannot be reversed, however, with rapid advances in medicine and surgical treatment, survival rates and long-term outcomes have increased and it is hoped that in future years with extensive research, better treatments will be found. For example , stem cell research is being investigated. With proper treatment, patients can recover some degree of function.
Acute medical management of spinal cord injury follows clinical guidelines following investigations such as X-rays, CT scans and MRI’s and neurological assessments.
Treatment usually commences at the scene of the accident with immobilization.
Admission to a specialist unit is the usual course following emergency admission to hospital. Patients are usually admitted to ITU and surgery is often necessary and in the first few days after injury, when spinal shock resolves, neurological function is reassessed. This is understandably a very upsetting time for families and patients. During the initial period, patients often find that the sudden loss of a previously taken-for-granted freedom of mobility and continence can lead to feelings of hopelessness and severe depression and so psychological assessment and treatment is a necessity.
After stabilization there is a focus on other medical conditions and effects of deconditioning.
Great emphasis is placed upon the provision of psychological support. Various studies have demonstrated that early intervention in this respect can lead to a greater degree of progress in rehabilitation and a more positive attitude. At this point, treatment of bowel and bladder dysfunction should also be aggressively pursued, in the hope of improving long-term renal prognosis.
It is usually the case that once a patient has been stabilized, they will be transferred to specialist centres of excellence for rehabilitation. There are four spinal injury units in the UK: Southport, Oswestry, Stoke Mandeville, and Glasgow. These units generally care for patients with traumatic spinal cord injuries.
The care of patients with acute traumatic injuries is generally a long process with a one to two-year pathway governed by detailed clinical guidelines produced by the British Society of Rehabilitation Medicine. These guidelines advocate a multidisciplinary team approach to management.
Regardless of the level of injury, individuals will be facing a variety of needs and challenges. It is crucial that newly injured patients be informed of the many issues and resources pertaining to their particular injury. One must be able to identify their medical, rehabilitation, and lifelong needs in order to lead a full and productive life.
If you or a member of your family have been affected by a spinal cord injury or other spinal injuries, our specialist serious injury team at What’s My Claim Worth are happy to speak with you. We are specialist lawyers with significant experience of dealing with clients who have been affected by life-changing injuries such as spinal cord injury.