by Kimberly Allen R.N.
A spinal cord injury or SCI is any injury to any part of the spinal cord or the nerves at the end of the spinal canal that is the result of injury not disease. the results in a change of normal motor, sensory, and/or autonomic function that can either be temporary or permanent. Not all spinal cord injuries involve trauma. In sports many athletes experience what they call “stingers” which is a transient loss of function. “Whiplash” is another type of spinal cod injury that can occur without trauma. There are an estimated 12,000 new cases of spinal cord injury in the US every year. The average age when injured has increased from 29 years of age to around 40 years of age. It is estimated that at least 80% of all spinal injuries occur in males. There are currently over 250,00 people in the US living with spinal cord injuries. In a study of children with spinal cord injury 67.7% of the children with spinal cord injuries were not wearing seatbelts, and in at least 30% of all children with spinal cord injuries alcohol and drugs were involved. In the US motor vehicle accidents are the most common cause of spinal cord injuries, though there are other cause including falls, sports injuries and violence like gunshot or stab wounds.
In 1982 the American Spinal Injury Association (ASIA) developed a classification scale for spinal cord injuries known as the “International Standards for Neurological and Functional Classification of Spinal Cord Injury” (INCSCI) which is still in use today. There are five categories for classifying spinal cord injury.
A is a “complete” spinal cord injury. There is no motor or sensory function .
B is an “incomplete” spinal cord injury where there is motor functrion below the injury including the sacral area, but no sensory function.
C is also an “incomplete” spinal cord injury in which there is motor function below the level of injury with more than half of the key muscles having less than a grade 3, which indicates full range of motion against gravity.
D is an “incomplete” spinal cord injury with motor function below the level of injury with at least half of the key muscle below the injury having a grade 3 or higher.
E. indicates “normal” both motor and sensory functions are with in normal limits.
All spinal cord injuries should be considered medical emergencies and treated as such. As with any serious injury the first priority is to be sure the injured is breathing and has a heart beat. If the injury is to the upper neck it can cause a loss of control of the muscles that are responsible for breathing. Once you have determined if the person is breathing and secured the airway it’s imperative to immobilize the person injured. This can be done several ways, the most common is use of a cervical collar and back board to prevent the spine from moving . If neither of these are available place something heavy on either side of the persons head, never move someone that has a suspected spinal cord injury, any movement can cause further damage. Always treat everyone suspected of having a spinal cord injury as if they have one until it can be ruled out. the degree of recovery depends on immediate intervention. After the diagnosis of spinal cord injury has been confirmed further treatment depends on the location and severity of the injury. Some may require surgery to remove bone fragments or to repair torn bloodvessels. The first goal of surgery is to relieve and pressure on the spinal cord and the second is to stabilize the spine. Frequently patients are started on high doses of steroids to reduce the inflammation and swelling in order to reduce the amount of damage to the spinal cord, however these are only effective if initiated in the first 8 hours after the injury.
An injury that results in any kind of paralysis is a life changing event and recovery from an event like that takes time. Anyone that suffers such a loss will need time to grieve and mourn the loss before they can move on. some may need help through counseling. The most important part of recovery is setting new goals and working to achieve them. There are numerous support groups available that can be helpful in many ways, including providing information on the latest research and treatments available for people with spinal cord injuries, your Dr can provide information on a group near you.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.