A Major Insult to the Spinal Cord
Whenever there’s an injury as serious as a spinal cord injury (SCI) the first big questions asked are how much function have I lost and will I regain any back? And as we all know, every SCI is as individual as a snowflake so there is no one complete or correct answer.
To get some answers we must start with accessing the damage to the spine. This is usually done in an emergency room. The first two tests they are most likely to perform include an MRI and a CT scan. It’s from these images that it can be determined the type and level of trauma that’s occurred. Then there’s the physical exam that will be done by the doctor to determine the level and completeness of your injury. This involves testing your muscle strength and your ability to sense light touch and pinprick sensations.
One very important thing to be aware of is that the MRI and CT scan will show damage to be at one level of the spine, but the level of function might indicate a higher level of injury. Why is this? It’s because additional damage can occur over days or weeks because of fluid accumulation, swelling, and inflammation in and around your spinal cord. This is the body’s normal defense mechanism when injured. What happens is your body rushes fluid to the injury site to provide an extra cushion around the spinal cord in addition to sending white blood cells to remove any foreign substances. However, there’s not much room around the spinal cord so this extra fluid buildup and swelling puts pressure on your nerves and may cause changes in virtually every system in the body. The good news is that after days or weeks the swelling begins to go down and so does the pressure on your nerves. You might see some improvement in function, perhaps even an improvement in functional level by a nerve segment or two. With many injuries, the individual may recover some function as late as 18 months after the injury. In very rare cases, people with spinal cord injury will regain some functioning years after the injury. However, only a small fraction of individuals sustaining a spinal cord injury recover all function.
Physical and occupational therapy is necessary to maintain and improve your function as well as help you adapt to new ways of doing things. Especially early on in a rehabilitation setting. It might be that you will need to continue therapy on your own, without a therapist present, but the goal is to help you return to the highest level of function and independence possible while improving your overall quality of life.
Keep in mind that recovery from an SCI takes time but many people who are paralyzed go on to lead productive and fulfilling lives.
It’s all good, so keep on rollin’ Roberta, RN, and Patty, BSN, RNC The Rollin’ RNs ™