When a person suffers a spinal injury, they can expect to be determined to have an incomplete SCI. This means that they have some feeling and movement in their body below their spinal injury. After this point, the person will need to undergo many tests and treatments to help with the healing process. The following is a description of the steps that will take place after the person has been diagnosed.
Classifying the Injury
There are several classifications in the American Spinal Injury Association (ASIA) Standards for the Classification of Spinal Cord Injury about a person’s injury and how it affects their mobility. Each classification is based on a person’s ability to feel and move their legs, specifically whether the person has any feeling below their injury level, whether they can move their legs without assistance, or if they require assistance from others in order to move their legs. The type of classification a person receives will depend on all of the above information as well as neurologic examination.
When you’re in the hospital, you’ll generally be offered a number of treatments and tests. Some are simply to monitor for complications, such as checking for pressure sores and bladder infections. You may also need surgery to fix any bones or tissue that have been injured.
After discharge, you’ll have a lot of choices to make regarding rehabilitation. You’ll need to find a doctor who can help manage your SCI and all the medical issues that go along with it. You’ll also need to decide whether you want home care or want to move into a nursing home.
Once you’ve gotten settled in at home, the next priority is figuring out how you’re going to get around. This can take some time; don’t feel rushed into buying a wheelchair or adapted car until you know what’s best for you.
The final, ongoing issue is managing your pain. This can be tricky, because there are so many different types of pain (usually divided into “acute” and “chronic”) and because pain medication has side effects and risks.
Stabilizing the Area
Once a person is injured, the first priority is to stabilize the patient’s breathing, blood pressure, and spinal column. In most cases, first responders will use a backboard and a cervical neck collar.
After a person with an SCI is stabilized, treatment is often focused on preventing further damage to the spinal cord. The goal of this treatment is to minimize secondary complications; unfortunately, there is no way to restore the function that has been lost. Research in this field, however, offers hope that some day we may be able to slow down or reverse the effects of SCI.
Neuroprotective therapies aim to stop or reduce the body’s immediate responses to the injury that may cause further spinal cord damage (i.e. swelling).
Surgery may also be used to stabilize the spine and prevent additional damage caused by moving the bones/vertebrae in the injured area.
Immediate treatment after an SCI can help reduce overall disability and improve life expectancy.
Neuroprotection
As a result of the injury, your body experiences a cascade of events that cause further damage to the spinal cord, including immediate swelling and inflammation. These processes can be reduced through neuroprotective therapies.
Neuroprotective therapies are not a cure. However, they may stop or reduce the body’s immediate responses to injury, preventing further spinal cord damage by limiting secondary injuries. This may allow you to achieve the best possible recovery and lessen the severity of your disability.
Because every injury is different, there’s no way to predict how much recovery time or medical treatment someone might need after this type of injury. It depends on the severity of the injury and how far down the spinal cord it occurred.
Some people with a mild-to-moderate SCI may be able to go home after a few weeks in the hospital. They may need periodic follow-ups and physical therapy for some time. Others with severe injuries, however, may require long-term care and rehabilitation, which can sometimes take as long as a year or more.
After sustaining an SCI, you may need various medical procedures to help your body function and minimize complications during recovery. Here are common surgeries and procedures:
Surgical Interventions
Once a patient is medically stable, he or she will meet with a surgeon to make the decision on surgical interventions. Surgery is recommended for many reasons such as removal of bone fragments, foreign objects, blood clots, herniated disks, fractured vertebrae, spinal tumors or anything that appears to be compressing the spine. Surgery to stabilize the spine helps to prevent future pain or deformity.
Decompression surgery. This procedure relieves pressure on the spinal cord caused by swelling or bleeding. It’s usually done within eight hours of injury or as soon as possible afterward.
Removal of bone fragments or foreign objects that enter the spinal canal through an open wound (called debridement). These fragments or objects can cut or tear nerve fibers in the spinal cord.
Bone grafts to fuse broken vertebrae together during surgery (called spinal fusion)
You may have one or more medical procedures to treat complications and help your recovery. These procedures are performed by specially trained doctors called neurosurgeons.
Respiratory Issues
Approximately 75% of people with an SCI also have a spinal cord injury in the chest area (thoracic). This may affect breathing. As a result, you may need a ventilator for long-term breathing assistance after your injury.
Some people with tetraplegia (paralysis of the arms and legs) may be able to breathe on their own without the help of a ventilator. But they still face an increased risk for breathing issues and infections. To prevent these issues, you’ll likely receive special training from a respiratory therapist to learn how to cough out mucus that collects in your lungs.
Autonomic dysreflexia (AD) is a complication that can occur after a spinal cord injury. It’s caused by an overactive sympathetic nervous system, which controls many automatic responses in your body, such as blood pressure and heart rate. If something causes this system to be overactive — such as constipation or bladder infection — it can cause AD. Signs include high blood pressure, pounding headache, sweating, nasal congestion, goose bumps and rapid heartbeat.
Unfortunately, there are a number of different issues that can occur after SCI. In order to ensure that you receive the best care possible, I encourage you to seek out disability services as soon as possible, preferably within a few months after your injury. They can help you deal with not only the physical issues of recovery but also the mental and emotional issues many people face after SCI. They can also help connect you to other resources within the community if there are any other concerns you have.
This is not everything that happens after an SCI, but it can help you know what to expect. It is important to know everything about your condition following an SCI, so that spinal cord injury sufferers can focus on their health and living their best life.
