Yes, before World War II, most people who sustained SCI died within weeks of their injury due to urinary dysfunction, respiratory infection or pressure sores. With the advent of modern antibiotics, modern materials such as plastics and latex, and better procedures for dealing with everyday issues of living with SCI, many people approach the life span of non-disabled individuals. Interestingly, other than level of injury, the type of rehabilitation facility used is the greatest indicator of long-term survival.
While recent advances in emergency care and rehabilitation allow many SCI patients to survive, methods for reducing the extent of injury and for restoring function are still limited. Immediate treatment for acute SCI includes techniques to relieve cord compression, prompt (within 8 hours of the injury) drug therapy with corticosteroids such as methylprednisolone to minimize cell damage, and stabilization of the vertebrae of the spine to prevent further injury.
The mean age is 33. Most persons are between 16 and 30 years of age. There is a 4:1 male:female ratio and most persons are white although blacks are at higher risk than whites. The percentage of cases occurring among blacks has been increasing in recent years.
Autonomic Dysreflexia (AD), also known as Hyperreflexia, is a potentially dangerous complication of spinal cord injury (SCI).
In AD, an individual’s blood pressure may rise to dangerous levels and if not treated can lead to stroke and possibly death. Individuals with SCI at the T-6 level or above are at greater risk.
AD usually occurs because of a noxious (irritating) stimulus below the level of the injury. Symptoms include headache, facial flush, perspiration, and a stuffy nose.
Adhesion of the spinal cord to the surrounding dura and tethering of the cord has several potential deleterious effects on the spinal cord. First, cerebrospinal fluid normally flow in the space between the spinal cord and dura. Adhesions between the spinal cord and dura may obstruct the fluid flow. The fluid then may be forced to flow in the central canal or through any channel that it can find.
Over time, this abnormal flow causes an enlarged cyst in the spinal cord called a syringomyelia or syrinx. Second, the spinal cord normally slide smoothly within its dural enclosure.
Let me rephrase your question. Only 10% of the axons in the spinal cord are necessary and sufficient for recovery of functions such as locomotion. That is probably why a majority of people with so-called “incomplete” spinal cord injury recover walking. As many as 50% of people with incomplete spinal cord injuries will recover walking.
Spinal cord injury may compromise breathing and coughing. After cervical spinal cord injury, artificial respiration may be necessary and pneumonia is common. Spinal cord injury paralyzes the bladder and a catheter must be placed in the bladder to drain urine. Continued pressure causes skin sores called decubiti. Cushioning vulnerable areas and regular turning prevents this.
The consequences of spinal cord injury depend on the level and severity of injury. Surgeons determine injury levels from the fracture site on the spinal column. This may differ from neurological level determined from sensory and motor loss.
Acute spinal cord injury refers to hours or days after spinal cord injury during which continued deterioration or tissue damage may occur. Shortly after an injury, the spinal cord often does not appear to be severely damaged even though there may be immediate functional loss. The injury initiates a cascade of chemical and cellular responses that contribute to further tissue damage, including inflammation, free radicals, and swelling (edema). The spinal cord may be compressed during this period.
Approximately 450,000 people live with SCI in the US. There are about 8,000 new SCIs every year; the majority of them (82%) involve males between the ages of 16-30.
These injuries result from motor vehicle accidents (42%), violence (24%), or falls (22%). Quadriplegia is slightly more common than paraplegia.