Spinal cord injury prognosis

Spinal Cord Injury Prognosis

Spinal cord injuries (SCI) vary considerably depending on the location in which damage has occurred and also the extent of the damage sustained. Spinal cord injury statistics suggest that there are currently between 243,000 and 347,000 people currently living with this type of injury in the USA, with around 12,000 new cases reported each year.

Those who have sustained a spinal cord injury will typically spend an average of 11 days in an acute care unit and 31 days in rehabilitation before being discharged. Of those, only 1% will have left the hospital after making a complete recovery (National SCI Statistical Center).

The prognosis for any spinal cord injury will depend on the severity and type of damage sustained. Injuries higher up the spinal cord, for example, are generally considered more serious simply because they cut off nerve messages to a large part of the body.

Whether the injury is complete or incomplete is another significant factor.

Here we take a closer look at what the prognosis looks like for spinal cord injury patients.

Complete vs Incomplete Spinal Cord Injuries

  • Complete spinal cord injuries are those where signals from the brain to the area of the body below the damage have been totally cut off, resulting in loss of sensation and the ability to move independently.
  • Incomplete SCIs involve partial damage to the spinal cord which means that some signals can get through while others can’t. There will be some motor and sensory function and the extent of this will depend on a wide range of factors.

As you might expect, if the spinal cord injury is incomplete, there is a much greater chance of some level of recovery. Research has greatly advanced in the area of SCIs in recent times, however, and even in the case of complete spinal cord injuries, there may still be some chance for improvements in the patient’s condition to be made.

In general, the first few months and first year of recovery are the most important and will largely determine the future prognosis of the individual. Here, exercise and rehabilitation should help improve motor movement and sensory quality for incomplete injuries. This is also a vital time when someone needs to come to terms with their injury and what it means for their future.

For complete spinal cord injuries, there are many challenges, especially where there is complete paralysis below the neck. Apart from lack of sensory and motor movement, individuals will need to contend with other issues such as issues bladder and bowel control as well as problems with breathing and regulating heart rate and blood pressure.

Level of Spinal Cord Injury

Anatomy of the Spine
Anatomy of the Spine

Physicians classify spinal cord injuries into several levels depending on which nerve they affect. These are:

  • Neck and C-1 to C-4
  • C-5
  • C-6
  • C-7 and T-1
  • T-1 to T-8
  • T-9 to T-12
  • L-1 to L-5
  • S-1 to S-5

Typically, the most severe kinds of injury are those involving the neck and C-1 to C-4 cranial nerves. This can mean the patient loses sensation in their arms, legs, and trunk, may not be able to control their breathing and will require intensive assistance with their daily living.

Damage to lower cervical nerves may mean that someone is able to lift and move their arms but not their legs. While breathing may be weakened, they can get around using a specialist wheelchair and live more independently.

Damage to the lower lumber nerves may mean loss of function in the hips and legs but the patient will be able to either walk with crutches or use a wheelchair quite easily.

Outlook following spinal cord injury

Lady in wheelchair at work

Physical therapy will be used to improve motion and occupational health services can help develop a daily living routine based on the type of injury.

The way in which spinal cord injury patients are supported and encouraged to live independently has changed dramatically over the last couple of decades. With the right support, the outlook for many is a lot more positive that they may initially think.

Treatment and Rehabilitation

There are spinal cord injury treatments available, both commercially and in the form of clinical trials which can help individuals improve their condition. Supportive therapies, such as physiotherapy, aqua-therapy, occupational therapy and massage therapy may also help the individual make better progress following their injury.

  • A person with a complete SCI that is lower down the spine will be able to use a wheelchair, introduce facilities to make their home living easier and even learn to drive a specially modified car.
  • Even with incomplete spinal cord injuries, a patient will probably have to make significant changes to their daily living and learn to cope with some form of disability.
  • A person who has a complete SCI that is higher up the spine will require a lot of support to live independently, including help getting dressed, eating, and going to the toilet.
  • Physicians and other healthcare professionals will normally work closely with SCI patients on the short, medium and long term outcomes but these will necessarily vary from person to person.

It’s not all about the physical outlook following an injury to the spine. One of the biggest issues that people face is maintaining their mental health and wellbeing, especially in the initial stages following their injury.

A Brighter Outlook

The prognosis for spinal cord injury patients has greatly improved with better treatments and rehabilitation services. While living with a disability is never easy, support with lifestyle changes and help facing challenges means that many individuals with an SCI live full and rewarding lives.