Understanding Spinal Injury
Spinal cord injuries may be caused by motor vehicle and sporting accidents, falls, gunshot wounds, tumors, disease, and decreased blood supply to the cord. Many of the patient’s bodily functions can be affected.
Anatomy Of The Spine
The spinal cord is enclosed within a column of bones called vertebrae (VER te bray). These bones support and protect the cord. The vertebrae are divided into sections:
- 7 Cervical (neck)
- 12 Thoracic (chest)
- 5 Lumbar (lower back)
- 5 Sacral
- 3 Coccygeal (tail bone)
Spinal nerves exit through small openings on each side of the vertebrae. Between each vertebrae is spongy material called a disc. The disc keeps the vertebrae from rubbing together and acts as a shock absorber. Ligaments hold the vertebrae together and allow the neck and back to twist and bend with ease.
Function Of The Spinal Cord
The spinal cord is a continuation of the brain. It is made up of nerves that carry signals between the brain and body. These signals or messages allow you to move, feel pain, touch, temperature, and position. Each nerve contacts a specific part of the body and affects specific functions.
- Cervical (neck) nerves control the diaphragm, neck, and arms.
- Thoracic nerves control the trunk.
- Lumbar nerves control the legs.
- Sacral nerves control the bowel, bladder and sexual function.
- Paralysis or Paresis (weakness).
- Changes in blood pressure & circulation.
- Difficulty regulating body temperature.
- Changes In bladder, bowel, & sexual function.
- Skin breakdown due to unrelieved pressure points.
How Long Is Recovery?
Generally spinal cord injury is not a condition from which you “recover” but learn to accommodate. Depending on the nature of the primary injury and the extent of other acquired injuries the prognosis will differ for each patient. The level of injury, and the corresponding physical limitations/abilities will be referred to by the location of the injury: A complete C-4 injury means that the person damaged at the fourth cervical vertabre will likely have limited or no functional use below the level of their shoulders.
The most important role the care giver plays is to be a positive and encouraging supporter and advocate, ensuring that the patient receives the best medical care and has access to the rehabilitation programs he/she needs to maximize his/her potential.
Where Do We Go From Here?
The prognosis is a very individual determination, based on many factors:
- Extent of injury/progress of disease.
- General pre-injury health, attitude.
- Level/rate of recovery, acceptance.
- Financial considerations.
- Need for continuing care, support.
Typically, the SCI patient will initially be placed in the acute hospital’s Intensive Care Unit (ICU). As the patient progresses, they may be transferred to the neurosciences unit and then be prepared for transfer to a rehabilitation facility. Inpatient rehabilitation can last from a few weeks to a few months and may be followed by outpatient rehab therapy.
The final step is returning to the community, which lasts a lifetime.
Spinal Cord Injury Program Components
Patricia Neal Rehabilitation Center offers an individualized Spinal Cord Injury Program utilizing state-of-the-art therapies designed to restore the patient to their maximum potential. Adult and pediatric multidisciplinary services are directed by physiatrists (rehabilitation doctors) and include:
- Physical therapy
- Occupational therapy
- Psychological services
- Wheelchair Seating /Positioning
- Speech/Language therapy
- Swallowing /Feeding program
- Social skills retraining
- Family/Patient education
- Sexuality program
- Adaptive aquatics program
- Animal-assisted program
- Home accessibility evaluation
- Independent /supervised living
- Extended services: home health, outpatient therapy, community reintegration, support groups, adaptive driving, and SCI clinic.
The Goals Of The Spinal Cord Injury Rehab Program
To provide the utmost quality and compassionate care to the person who has a spinal cord injury.
To help the patient and caregivers understand the injury and reasons for each step in the plan of care.
To help the patient and caregivers cope emotionally with the injury and the disability that may result.
To work with patient and caregiver in developing a realistic plan for discharge, follow-up, and community reintegration.
For more information about spinal cord injury and rehabilitation contact: The National Spinal Cord Injury Association or
Patricia Neal Rehabilitation Center
Fort Sanders Regional Medical Center
1901 Clinch Ave. Knoxville, TN 37916
Admission: (865) 331-1446
Education: (865) 331-4943
1 800 PAT-NEAL (728-6325)