| Spinal Court Injuries Treatment in the | | | | independence in tasks such as turning |
| days and weeks following a spinal cord | | | | pages, using a telephone and operating |
| injury | | | | lights and appliances. |
| There are several types of treatment in | | | | Mobility: Can operate an electric |
| the short term for a spinal cord injury. | | | | wheelchair by using a head control, |
| First, the spine in the area of the | | | | mouth stick, or chin control. A power |
| injured spinal cord is immobilized (held | | | | tilt wheelchair allows independent |
| in place so it can't move) to prevent | | | | pressure relief from sitting in one |
| further injury to the cord. For injuries | | | | position. |
| to the neck, immobilizing the spine may | | | | Usually has head and neck control. |
| include placing the head in a | | | | Breathing: May initially require a |
| ââ¬Å"haloââ¬? (a device | | | | ventilator for breathing but usually |
| that prevents the head from moving). For | | | | adjusts to breathing full-time without |
| spinal cord injuries in the back, casts, | | | | ventilator assistance. Communication: |
| braces and straps may be temporarily | | | | Normal. |
| used to keep the back from moving. | | | | Daily tasks: With specialized equipment |
| To reduce swelling in the spinal cord | | | | may have limited independence in feeding |
| caused by injury, steroid medication is | | | | and independently operating an |
| usually given during the first 24 hours | | | | adjustable bed with an adaptive |
| following injury. Other medical | | | | controller. |
| treatment is often necessary, depending | | | | Typically has head and neck control, can |
| on complications that may develop. | | | | shrug shoulder and has shoulder control. |
| Because traumatic injury to the spinal | | | | Can bend elbows and turn palms face up. |
| cord usually involves an injury to the | | | | Daily tasks: Independence with eating, |
| bones and ligaments of the spine, | | | | drinking, face washing, brushing teeth, |
| surgery may be performed. The aim of | | | | face shaving and hair care after |
| some surgeries is to remove bone (this | | | | assistance in setting up specialized |
| is called "decompression") that is | | | | equipment. |
| pressing on or into the spinal cord. A | | | | Health care: Can help in preventing |
| surgeon may also want to stabilize or | | | | pressure ulcers by leaning forward or |
| realign the spine in the area of the | | | | side-to-side. |
| spinal cord injury when the vertebrae or | | | | Has movement in head, neck, shoulders, |
| ligaments have been damaged. | | | | arms and wrists. Can shrug shoulders, |
| Metal rods or cages and screws may be | | | | bend elbows, turn palms up and down and |
| attached to normal vertebrae to prevent | | | | extend wrists. Daily tasks: With help of |
| movement of fractured vertebrae and the | | | | specialized equipment can perform with |
| vertebrae may be | | | | greater ease and independence daily |
| ââ¬Å"fusedââ¬? together | | | | tasks of feeding, bathing, grooming, |
| using bone graft for the same reason. | | | | personal hygiene and dressing. May |
| Grafts, which involve the growth of new | | | | independently perform light housekeeping |
| bone tissue into adjacent bone, require | | | | duties. |
| time to ââ¬Å"takeââ¬?. | | | | Health care: Can independently perform |
| Consequently, metal | | | | skin checks, turn in bed, and relieve |
| ââ¬Å"hardwareââ¬? is | | | | pressure while sitting. Mobility: Some |
| usually needed to hold the spine in | | | | individuals can independently do |
| place while the graft is taking. | | | | transfers but often require a sliding |
| Stretching of the spine using weights | | | | board. Can use a manual wheelchair for |
| and pulleys (called traction) may also | | | | daily activities but may use power |
| help with alignment of the spine. | | | | wheelchair for greater independence. |
| Rehabilitation Hospitals | | | | Has similar movement as an individual |
| Rehabilitation hospitals provide several | | | | with C6 with added ability to straighten |
| different types of specialists to help | | | | elbows. |
| in the recovery process. Physicians who | | | | Daily tasks: Able to perform household |
| specialize in physical and | | | | duties. Needs fewer adaptive aids in |
| rehabilitation medicine (called | | | | independent living. Health care: Able |
| physiatrists) usually supervise the | | | | to do wheelchair pushups for pressure |
| rehabilitation program. Physical | | | | relief. Mobility: Daily use of manual |
| therapists plan therapy to strengthen | | | | wheelchair. Can transfer with greater |
| muscles in parts of the body that still | | | | ease. |
| function. Occupational therapists | | | | Has added strength and coordination of |
| specialize in training individuals who | | | | fingers with limited or even normal hand |
| have lost muscle strength or | | | | function. Daily tasks: Can live |
| coordination to relearn the tasks of | | | | independently without assistive devices |
| daily living, such as eating, dressing, | | | | in feeding, bathing, grooming, oral and |
| and grooming. They also train people in | | | | facial hygiene, dressing, and bladder |
| how to use assistive equipment and | | | | and bowel management. Mobility: Uses |
| braces. Social workers help in finding | | | | manual wheelchair. Can transfer |
| resources to pay for equipment, home | | | | independently. |
| modifications, and attendant care. | | | | Has normal motor function in head, neck, |
| Family members also receive education in | | | | shoulders, arms, hands and fingers. Has |
| assisting the injured person. Are | | | | increased use of rib and chest muscles |
| spinal cord injuries permanent? | | | | and may have some trunk control. Daily |
| Whether a spinal cord injury is | | | | tasks: Should be totally independent |
| permanent or not will depend in part on | | | | with all activities. Mobility: A few |
| how severe the injury is, which can | | | | individuals are capable of limited |
| range from a mild bruise (contusion) to | | | | walking with extensive bracing. However, |
| the cord being severed in two. Even when | | | | this requires extremely high energy and |
| injuries are permanent, any survivors, | | | | puts stress on the upper body, which can |
| including those with severe spinal cord | | | | lead to damage of upper joints. There is |
| injuries, achieve a one or two level of | | | | no functional advantage with this kind |
| ââ¬Å"functionalââ¬? | | | | of walking. Mortality |
| improvement following treatment and | | | | Because of the force that is required to |
| rehabilitation (and some survivors | | | | fracture the spine, many spinal |
| achieve an even better recovery). | | | | cord-injured patients suffer significant |
| Limited movement of head and neck: | | | | damage to the chest or abdomen. Many of |
| Breathing: Depends on a ventilator for | | | | these associated injuries are fatal. For |
| breathing. Communication: Talking may | | | | isolated spinal cord injuries the |
| be very limited or impossible. If | | | | mortality after one year is about 5-7%. |
| ability to talk is limited, | | | | If a patient survives the first 24 hours |
| communication can be accomplished | | | | after spinal cord injury, the likelihood |
| independently with a mouth stick and | | | | of survival for ten years is |
| assistive technologies like a computer | | | | approximately 75-80%. The ten-year |
| for speech or typing. Effective | | | | survival rate for patients who survived |
| communication allows the survivor to | | | | the first year after injury is 87%. Not |
| direct caregivers with daily activities | | | | surprisingly, younger survivors and |
| such as bathing, dressing, personal | | | | those with incomplete injuries do better |
| hygiene, transferring, and bladder and | | | | than older survivors and those with |
| bowel management. Daily tasks: | | | | complete injuries. |
| Assistive technology allows for | | | | |