Spinal Cord Injuries – and Treatment – Can Change Lives

The effects of spinal cord injury (SCI) can be devastating. Depending on the type of injury and the location at which it occurs on the spine, SCIs can cause changes in virtually every system in the body.

When an SCI occurs the spinal cord usually swells. After days or weeks, the swelling begins to diminish and people regain different levels of body function. Only a very small fraction of individuals sustaining SCIs recover all functioning.

The Froedtert and Medical College Spinal Cord Injury Center, opened in 1986, is nationally recognized as a facility that offers state-of-the-art rehabilitation care to people who have experienced spinal trauma and spinal cord injuries.

There are excellent reasons for the attention. Statistics show that patients treated at the Froedtert and Medical College Spinal Cord Injury Center recover more fully than patients who receive care at other facilities, functioning at a level that is 33.6% higher than the national average. Patients also recover more quickly; their stay at the Center was about 29% shorter than the average.

Dennis Maiman, MD, Medical College of Wisconsin Professor of Neurosurgery and Medical Director of the Spinal Cord Injury Center, attributes much of that success to the Center’s programming. “The careful integration of our rehabilitation program makes all the difference,” says Dr. Maiman. “In most spinal cord injury rehabilitation programs, patients are hospitalized first, and then are transferred to a rehabilitation program. Our patients begin rehabilitation almost immediately.”

In addition, the Center takes a transdisciplinary approach to patients’ rehabilitation, explains Dr. Maiman. There are many staff members involved in each patient’s rehabilitation and they communicate continuously regarding patients’ treatment and progress. This type of continuity, along with rigorous attention to the highest standards of care, help shorten the length of a patient’s stay and contribute to their complete recovery.

More than Physical Therapy
Besides a loss of sensation or motor functioning, individuals with SCI also experience other changes. For example, they may have bowel and/or bladder dysfunction. Sexual functioning is frequently disrupted or lost with SCI.

Rehabilitation teams at the Medical College Spinal Cord Injury Center include physical therapists, occupational therapists and recreational therapists. “Patients need to learn how to function on a daily basis and how to get back to work, but they also need to learn how to have fun,” says Dr. Maiman. “It’s an important part of their integration back into their normal lives.” The staff also includes a physiatrist (an MD who helps in the rehabilitation process), and a psychologist. “Some of our patients have suffered significant losses, and need help dealing with the stresses of their injury,” notes Dr. Maiman. Patients’ families are considered an integral part of the health care team, adding to the overall health and recovery of the patient.

“We continue to make great strides in the treatment of spinal cord injuries,” says Dr. Maiman. While there is no “cure” for spinal cord injuries, Dr. Maiman reports that ongoing advances in surgical procedures and techniques are helping patients return to their homes, jobs and communities as quickly as possible. Physicians are reconstructing the spine, performing complex surgeries to treat injuries, and using a wide variety of drugs to prevent the further progression of patients’ spinal cord disorders.

Leading Causes of Spinal Cord Injury
About 450,000 people in the US live with SCI. There are about 10,000 new SCIs every year; the majority of them (82%) involve males between the ages of 16-30. Dr. Maiman reports that the most common cause of spinal cord injury is motor vehicle crashes. Sports injuries – such as those sustained in diving or football accidents – are another factor in spinal cord injuries. In addition, elderly patients are at risk for falls that can result in spinal cord injuries. “And unfortunately,” says Dr. Maiman, “many spinal cord injuries are the result of gunshot or knife wounds.”

Spring and summer bring opportunities for many outside activities, and a caution from Dr. Maiman: “People get out there and do crazy things this time of year,” he says, “like diving into lakes and rivers before they know how deep the water is.” Wisconsin typically sees 50 to 60 paralyzing spinal cord injuries per year, many of these due to our proximity to so many natural waterways. Dr. Maiman emphasizes that it’s important to perform a quick safety check before jumping or diving into water. This year, in particular, water levels are significantly lower than in years past, and being unaware of water depth puts people at risk of serious injury if the water turns out to be shallower that expected. Even at home or public pools, be sure there is a minimum of five to six feet of water before diving in, and check for floating debris or other swimmers in the area.

Although there is no cure for SCI, researchers have made many advances in treatment, including some that could result in a decreased amount of damage at the time of the injury. Steroid drugs reduce swelling, which is a common cause of secondary damage. Certain experimental drugs, although not yet completely understood, appear to reduce the loss of function.

Ultimately, avoidance is the best way to reduce the incidence of spinal cord injuries. The most important thing to remember about spinal cord injuries, says Dr. Maiman, is that the vast majority of them are preventable. Driving safely is of utmost importance, as is using caution when undertaking recreational activities. “Use common sense,” he urges. “Think of the implications of your actions and plan accordingly.”

P.J. Early
HealthLink Contributing Writer

This article includes information from the Centers for Disease Control and Prevention.

For more information, see the HealthLink article The Facts about Spinal Cord Injury.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.