Every year, more than 12,000 people in the United States sustain a spinal cord injury. A spinal cord injury / disease (SCI/D) changes a person’s life in an instant, and can have life-changing consequences.
What is a spinal cord injury / disease?
More than 5 million Americans are living with paralysis, one in 4 of them a result of spinal cord injury or disease. The spinal cord is the major channel through which motor and sensory information travels between the brain and body.
When injury or disease of the spinal cord occurs, conduction of sensory and motor signals across the site of lesion(s) is impaired, resulting in loss of motor and/or sensory function. To further define, tetraplegia refers to impairment of function in the arms as well as the trunk, legs and pelvic organs. Paraplegia refers to impairment of arm functioning is spared and trunk, legs and pelvic organ involvement is dependent of the level of injury.
Injuries are classified as incomplete if partial preservation of sensory and/or motor function is present below the level of injury, to include sensation at the lowest segment of spinal cord; and complete when sensory and motor function is absent in the lowest segment of the spinal cord.
Life Expectancy & Symptoms
Prior to the 1970’s, life expectancy for people with SCI/D was significantly reduced, mostly because of urological or respiratory infections. Since the improved management of infections, life expectancy has increased; however, respiratory diseases and septicemia remain the leading cause of death for individuals with SCI/D. It is important for caregivers and clinicians to recognize atypical signs and symptoms of infection, including, but not limited to fever, chills, spasms, nausea, vomiting, and fatigue as warning signs of infection in individuals with SCI/D.
Autonomic Dysreflexia (AD)
Autonomic Dysreflexia (AD) is a preventable condition that can result in death if not quickly treated. Those with spinal cord injury at the sixth nerve of the thoracic spine or above are most commonly at risk, and in some cases the seventh and eighth nerve. AD can affect individuals with complete and incomplete injuries.
Common signs and symptoms of AD include sudden/significant elevation of blood pressure, severe headache, profuse sweating, goosebumps, blurred vision, seeing spots, flushed skin, nasal congestion, slowed pulse, tightness in chest, and anxiety. If any of these are experienced, emergency treatment must be initiated to include: sit up or raise head to 90 degrees and remain upright until blood pressure is normal, based on individuals baseline blood pressure; check/empty bowel or bladder; loosen or remove tight clothing; monitor blood pressure every 5 minutes; and call health care professional, even if symptoms resolve.
Spinal Cord Disease
In addition to those injured traumatically, neurologic impairment of the spinal cord (myelopathy) may predominantly occur in diseases such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), benign or malignant tumors, spinal stenosis, arterio-venous malformations, epidural abscess, and other vascular, inflammatory, or infections of the spinal cord itself.
Similar to spinal cord injury, spinal cord disease causes various patterns of deficits depending on which nerve tracts within the spinal cord or which spinal roots outside of the cord are damaged. Common warning signs of spinal cord disease include paresis, loss of sensation, change in reflexes, and autonomic dysfunction (bowel/bladder, erectile dysfunction, loss of ability to sweat).
Spinal Cord Injury / Disease Care
With increased longevity for persons with SCI/D, co-morbidities such as metabolic disease, endocrine disease, and musculoskeletal disorders are becoming increasingly common and require comprehensive specialty care for the prevention or early detection of health complications seen in the aging population.
Within the Veterans Health Administration, the Spinal Cord Injury and Disease System of Care provides an interdisciplinary team approach to manage the physical, psychological, environmental, and interpersonal support of individuals living with SCI/D. At the onset of rehabilitation and throughout life time, this comprehensive system of care helps individuals with SCI/D attain, preserve, and enhance the health and quality of life. Here’s how to find one near you.