Jonah Patel
Spinal cord injuries (SCI) refer to damage to the spinal cord, which is a bundle of nerves and nerve fibres that transmit signals from the brain to the rest of the body. This damage can be caused by trauma, such as road traffic accidents, falls, violence, or non-traumatic causes like tumours, degenerative conditions, infections, toxins, or birth defects. In Ohio, there are several rehabilitation centres and support groups for people with spinal cord injuries. The Ohio State University Medical Center offers a full range of services for patients with spinal cord injuries, including comprehensive rehabilitative care programs that address the unique physical, social, psychological, emotional, and economic issues accompanying spinal cord injuries. The Miami Valley Hospital Rehabilitation Institute of Ohio is another facility that provides a wide variety of rehabilitation services, including physiatrists, nurses, physical therapists, occupational therapists, and more.
| Characteristics | Values |
|---|---|
| Definition | Damage to the spinal cord, a bundle of nerve fibers that links the brain to nerves throughout the body |
| Causes | Trauma (e.g. falls, road traffic injuries, violence, earthquakes), non-traumatic causes (e.g. tumors, degenerative and vascular conditions, infections, toxins, birth defects) |
| Symptoms | Temporary or permanent changes in feeling, movement, strength, and body functions below the injury site; paralysis can be immediate or develop over time |
| Severity | Minor and manageable to severe and permanent; depends on the part of the spinal cord that is damaged and the extent of the damage |
| Classification | Complete injury (no function, sensation, or movement below the injury site), incomplete injury (some movement, sensation, or function remains below the injury site) |
| Treatment | Prevention of further damage, sedatives to prevent movement, breathing tube if needed, rehabilitation to improve function and independence |
| Support | Spinal cord injury support groups in Ohio, such as the Northeast or Northwest Ohio Chapter of the National Spinal Cord Injury Association |
| Rehabilitation Centers | Ohio State University Medical Center, Miami Valley Hospital Rehabilitation Institute of Ohio, MetroHealth Rehabilitation Institute, Ohio State University Wexner Medical Center |
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What You'll Learn
Trauma and non-traumatic causes
Spinal cord injuries (SCI) are damage to the spinal cord, a bundle of nerve fibres that sends and receives signals from the brain. The spinal cord extends from the brain to the lower back through a canal in the vertebrae. An SCI can interrupt nerve signals and control over muscle movement, causing temporary or permanent changes in feeling, movement, strength, and body functions below the injury site. The severity of an SCI depends on the location and extent of the damage.
Traumatic causes of SCI include falls, road traffic injuries, violence, earthquakes, and conflicts. These are often preventable through interventions such as improved road safety, window guards, and policies to reduce violence. Traumatic injuries can cause direct damage to the spinal cord or the surrounding tissue, bones, and vertebrae. This can include herniated discs, vascular irregularities, bleeding, inflammation, and ligament injuries.
Non-traumatic causes of SCI are also increasing, especially in ageing populations. These include non-communicable diseases such as tumours, degenerative and vascular conditions, infections, toxins, and birth defects. Early diagnosis and treatment of these underlying health conditions can help prevent non-traumatic SCI.
In addition to the cause, the type of SCI can be categorised as either complete or incomplete. A complete SCI means there is a total loss of nerve communication and function below the injury site, resulting in paralysis. In contrast, an incomplete SCI allows some nerve messages to reach the brain, leaving the person with some feeling, function, and muscle control below the injury.
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Paralysis and other symptoms
Spinal cord injuries (SCI) refer to damage to the spinal cord, which is a bundle of nerve fibres that sends and receives signals from the brain. The spinal cord extends from the brain to the lower back through a canal in the vertebrae. The nerves in different sections of the spinal cord control different parts of the body. The cervical spine, for instance, is located in the neck and controls signals to the back of the head, neck, shoulders, arms, hands, and diaphragm. An injury to the upper part of the spinal cord can cause paralysis in most of the body and affect all limbs (tetraplegia or quadriplegia). On the other hand, an injury that occurs lower down the spinal cord may only affect a person's lower body and legs (paraplegia).
Paralysis can occur immediately upon injury (primary damage) or develop over time due to bleeding and swelling in the spinal cord and cell death (secondary damage). Incomplete injuries allow some nerve messages to be sent to or from the brain, resulting in some feeling, function, and muscle control below the injury site. Conversely, complete injuries mean there is no nerve communication below the injury site, leading to a total loss of muscle control, feeling, and function in the affected areas.
The severity of SCI-related impairment depends on the injury's location and magnitude in the spinal cord. SCIs can be classified as either incomplete or complete. An incomplete SCI affects some nerve lanes, leaving others open, resulting in some abilities remaining intact below the injury. A complete SCI, however, affects all nerve lanes, leading to a permanent loss of all abilities below the injury, including paralysis.
The symptoms of spinal cord injuries depend on the specific location and extent of the damage. They can range from minor and manageable to severe and permanent. In addition to paralysis, other symptoms of spinal cord injuries include temporary or permanent changes in sensation, movement, strength, and body functions below the injury site. Furthermore, people with SCI are at risk of developing secondary conditions that can be debilitating or even life-threatening.
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Diagnosis and imaging techniques
Spinal cord injuries (SCI) are not always immediately recognizable and can range from minor to severe. They can be caused by trauma to the cervical or thoracic spine, resulting in a complete or incomplete injury. A complete injury means there is no sensation or movement below the injury site, whereas an incomplete injury means some function remains. Symptoms of SCI include acute head, neck, or back pain, a decline of feeling in the extremities, loss of control over parts of the body, urinary or bowel problems, difficulty walking, pain or pressure in the chest, difficulty breathing, and lumps on the head or spine.
The diagnosis of SCI involves a thorough evaluation of the patient's symptoms and medical history. If a patient is suspected of having an SCI, they must be carefully transported to an emergency room or trauma center, keeping the spine immobile to prevent further injury. Doctors will then perform a physical examination to assess the patient's sensory function and movement. Diagnostic tests, such as X-rays, can be used to detect fractures or damage to the bones of the spine.
Magnetic resonance imaging (MRI) is a crucial diagnostic tool for visualizing the spinal cord. It uses magnets, radiofrequencies, and a computer to produce detailed images of the spine and surrounding structures. MRI techniques such as diffusion-weighted imaging (DWI) and susceptibility-weighted images (SWI) are useful for identifying hemorrhages and lesions after spinal trauma. Functional MRI (fMRI) can also map out areas of spinal function related to motor and sensory abilities.
Computed tomography (CT) scans are complementary to MRI and are particularly useful for identifying acute hemorrhages and vascular abnormalities after SCI. CT angiography is helpful for visualizing the craniocervical junction and the spinal axis in cases of scoliosis.
Other advanced imaging techniques for SCI include dynamic contrast-enhanced (DCE) MRI, which can quantify vascular changes, and perfusion MRI, which can assess blood flow and perfusion in the injured spinal cord. PET imaging and SPECT imaging are also used to evaluate blood flow and neural repair. These imaging techniques are essential for patient management and assessing the response to treatment.
The ASIA (American Spinal Injury Association) Impairment Scale is a standard tool used to diagnose the severity of SCI and predict the extent of recovery. It has five classification levels, ranging from complete loss of neural function to a completely normal state.
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Treatment and rehabilitation
Spinal cord injuries (SCI) can have devastating consequences, including permanent paralysis and serious disability. While there is currently no cure for SCI, rehabilitation is crucial for improving patients' quality of life. The treatment and rehabilitation process is typically long, expensive, and exhausting, requiring a multidisciplinary approach and a team of specialists.
Ohio State University Medical Center offers a comprehensive Spinal Cord Injury Rehabilitation Program through its Wexner Medical Center. The program aims to help patients with total or partial loss of sensation, movement, or function due to SCI. It provides personalized care, addressing the unique physical, social, psychological, emotional, and economic issues that accompany SCI. The goal is to help patients optimize their abilities and achieve the highest possible level of independence.
The Ohio State University Medical Center's rehabilitation program offers a full range of services, including pain management and increasing function and independence. The program utilizes cutting-edge research and state-of-the-art technology, partnering with the Cleveland Functional Electrical Stimulation Center. It is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF).
Another renowned facility for SCI rehabilitation in Ohio is the Miami Valley Hospital Rehabilitation Institute. This 39-bed facility offers a wide range of rehabilitation services, including a Spinal Cord Injury Program focused on helping patients adjust to their injuries and achieve maximum independence. The program addresses various issues, such as skin care, respiratory care, bowel and bladder maintenance, mobility, and sexuality. The institute is accredited by JCAHO and CARF and is known for its individualized care.
The road to recovery from an SCI is challenging and often life-long. Early rehabilitation is crucial to preventing complications and maximizing patients' functional abilities. With the help of skilled professionals, patients can learn new ways to perform daily living activities and adapt to their new normal. While the improvements may vary, there is almost always hope for at least some progress in severity, level, and functional abilities.
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Support groups
Spinal cord injuries can be life-changing for patients and their families, causing disruptive changes to every aspect of life. Support groups for spinal cord injury survivors are located all over the United States, including Ohio, and aim to unite survivors on their road to recovery.
Ohio State University Medical Center offers a full range of rehabilitation services for patients with spinal cord injuries, helping them to increase their function and independence. The centre also provides education and support services targeted at family members and caregivers, promoting a team approach to treatment.
The Spinal Cord Injury Program at Miami Valley Hospital Rehabilitation Institute of Ohio helps patients adjust to their injuries and achieve maximum independence. The program addresses issues such as skin care, respiratory care, bowel and bladder maintenance, mobility, and sexuality.
MetroHealth Rehabilitation Institute, located at the MetroHealth Medical Center in Cleveland, is affiliated with Case Western Reserve University and is one of 14 facilities in the country designated a Spinal Cord Model System Program. The institute promotes a goal-oriented approach using an interdisciplinary team focused on returning each patient to maximum function and independence.
There are also support groups in Cincinnati and Warren, Ohio, that meet monthly. These groups provide an opportunity for survivors to connect with others going through similar challenges and provide support and friendship.
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Frequently asked questions
Spinal cord injuries (SCI) refer to damage to the spinal cord, which is a bundle of nerves and nerve fibres that transmit signals from the brain to other parts of the body.
Most SCI cases are due to trauma, including falls, road traffic injuries, violence, and sports injuries. Non-traumatic causes include tumours, degenerative and vascular conditions, infections, toxins, or birth defects.
The symptoms of spinal cord injuries depend on the part of the spinal cord that is damaged and the severity of the damage. Injuries to the upper part of the spinal cord can cause paralysis in most of the body and affect all limbs (tetraplegia or quadriplegia). Injuries lower down the spinal cord may only affect a person's lower body and legs (paraplegia).
Magnetic resonance imaging (MRI) and computerized tomography (CT) scans can be used to detect spinal cord injuries. MRI scans can show brain and spinal trauma, herniated discs, vascular irregularities, bleeding, inflammation, and ligament injuries. CT scans can detect bone fractures, bleeding, and spinal stenosis (narrowing of the spinal canal).
