Overview of Spinal Cord Injuries

Your spinal cord is a crucial bundle of nerves running  down the center of your back, carrying signals between your brain and the rest of your body. When the spinal cord is injured, these signals are disrupted, often leading to significant changes in strength, sensation, and bodily functions below the site of the injury. Let’s explore what SCI entails, its causes, and its impact on the body.

• What are spinal cord injuries?

SCI refers to damage to any part of the spinal cord or the nerves at the end of the spinal canal (known as the cauda equina). SCI results in a complete or incomplete loss of sensory and/or motor functions below the injury level, significantly reducing the ability to perform daily activities such as walking, using one’s hands, and managing bowel and bladder functions, as well as washing and dressing oneself. These limitations are further exacerbated by misconceptions, negative attitudes, and physical barriers to basic mobility, which restrict independence and full societal participation. Consequently, SCI is a major cause of long-term disability.

Global estimates from 2021 indicate that approximately 15.4 million people were living with SCI. Males are more frequently affected by SCI than females, exhibiting higher prevalence rates and years lived with disability (YLDs). A critical question emerges: What factors are driving this phenomenon? We will analyze the common causes of spinal cord injuries.

• How Do Spinal Cord Injuries Occur?

Many things can cause SCI. The more common injuries occur when the area of the spine or neck is bent or compressed. Here are some of the most common causes:

• Falls 
• Motor vehicle accidents (automobiles, motorcycles, and being struck as a pedestrian) 
• Sports injuries 
• Diving accidents 
• Trampoline accidents 
• Violence (gunshot or stab wounds) 
• Infections that form an abscess on the spinal cord
• Birth injuries.

• Types of SCI

Spinal cord injuries are classified as either complete or incomplete:

• Signs and symptoms

Depending on injury severity and location, people with SCI can experience

• partial or complete loss of sensory and/or motor functions (including respiratory muscle functions)
• bowel, bladder and sexual dysfunction
• dysregulation of blood pressure, heart rate, and/or body temperature.

SCI is often associated with a risk of developing complications, including debilitating and potentially life-threatening secondary conditions, such as

• spasticity
• (chronic) pain
• urinary tract infections
• pressure ulcers
• respiratory complications
• autonomic dysreflexia
• deep vein thrombosis
• osteoporosis.

Now that we’ve acknowledged the seriousness of SCI and its aftermath, the natural question arises: how can individuals with SCI be treated to mitigate these effects and work towards recovery?

Can SCI be prevented?

There is no sure way to prevent SCI, but there are many steps you can take that might lower your risk, including

• Avoid Impaired Driving: Refrain from driving under the influence of alcohol or drugs, as impaired judgment significantly increases the likelihood of accidents leading to SCI.
• Use Seat Belts: Ensure that you and all passengers wear seat belts properly whenever in a vehicle. Seat belts are essential for minimizing the impact of collisions and reducing the risk of spinal injuries.
• Prevent Falls: Take precautions to prevent falls around your home by securing rugs, using non-slip mats in bathrooms, and installing handrails on stairs. These measures can prevent falls that might result in spinal cord damage.
• Secure Firearms: Store firearms unloaded and securely locked away to prevent accidental discharge or unauthorized use, which can cause serious injuries.
• Wear Protective Gear: When engaging in activities such as motorcycle riding, biking, skiing, hockey, or football, always wear appropriate helmets and protective gear. These items are crucial for preventing head injuries that could lead to SCI.

By incorporating these preventive actions into your daily routine, you can significantly reduce the risk of spinal cord injury and promote overall safety and well-being.

How is SCI treated?

Treatment for SCI aims to minimize further damage, manage symptoms, and improve quality of life. Your treatment plan may involve:

• Close monitoring and medical care in a specialized intensive care unit (ICU).
• Medications: such as corticosteroids, prescribed to reduce swelling in the spinal cord.
• Surgery: Surgical intervention may be necessary to remove bone fragments, repair herniated disks, or stabilize the spine with metal plates or screws.
• Insertion of a bladder catheter to facilitate urine drainage into a collection bag.
• Placement of a feeding tube through the nostril or directly into the abdomen to provide additional nutrition and calories.
• Rehabilitation: Long-term rehabilitation involves physical therapy, occupational therapy, and other interventions to maximize independence and quality of life.

Rehabilitation Strategies for SCI

Understanding the complexities of SCI , recovering from a spinal cord injury often requires prolonged hospitalization and rehabilitation treatment.The healthcare team will help educate your family after hospitalization and rehabilitation on how to help care for you at home and understand the specific problems that require immediate medical attention.

As well as your doctor, other healthcare professionals who may be a part of your rehabilitation team include:

• Dietitians and nutritionists                       
• Nursing professionals 
• Occupational therapists 
• Physiotherapists 
• Prosthetists and orthotists
• Psychologists 
• Social work and counselling professionals 
• Specialist medical practitioners/PRM physicians 
• Speech and language therapists/pathologists

Your rehabilitation may include activities to improve:

• Range of motion exercises
• Muscle-strengthening exercises
• Balance training
• Gait training
• Mobility training (incl. wheelchair skills training)
• Provision and training in the use of assistive products for mobility

Rehabilitation can also involve technologies such as video games, robotics and functional electrical stimulation to improve various skills.

Self-care

Effective self-management is essential for addressing SCI-related impairments, promoting optimal functioning, and preventing secondary conditions. Self-management involves mastering skills to implement effective self-care strategies independently and adopt a healthy lifestyle.

Support Networks

These support networks can be valuable in providing information, assistance, and community for individuals and families navigating life with spinal cord injury.

Based on the overview provided, we hope you now have a comprehensive understanding of SCI. In the unfortunate event that you or a loved one experiences SCI, early proper management and subsequent rehabilitation therapy will play a crucial role in restoring function and improving quality of life. We will delve deeper into these topics in the following chapters.