Generally, the earlier recovery begins and the more rapid its progress, the better the prognosis. In scientific studies, most recovery occurs during the first six months, and may continue up to two years post injury. Patients with incomplete spinal cord injury lesions have a better chance of recovery than those with complete lesions.
Research and development for “fixing severed spinal cords” has been ongoing for decades. Allocation of funds for this disorder, however, is scarce when compared to more common maladies such as coronary artery disease. Since the unfortunate accident of Christopher Reeves that rendered him a Ventilator-dependent tetraplegic, SCI has entered into the limelight and more money has been donated from the private sector. It is therefore hoped that within the next few decades a breakthrough for SCI may be established. It is the dream of many individuals that complete paralysis of acute SCI may be prevented and chronically injured persons may regain Motor function.
In the meantime, because of medical advances in early and appropriate intervention in acute SCI, patients are living longer and experiencing more related complications as a result. The medical cost may be considerable as the SCI patient may live many years post injury. Experience shows that the more comprehensive the initial education and training are, the better the patient and family are in understanding the manifestations of spinal injury and in preventing complications through the years.
A person with SCI, especially with a diagnosis of ASIA A Tetraplegia, should be regularly followed by a team of physicians including a primary care practitioner annually, a specialist in SCI Rehabilitation (such as a Physiatrist) at least every other year and for special circumstances and a urologist per medical discretion. Referrals to medical and ancillary specialists should not be delayed. One example of potential cost savings is to have a therapist rather than a vendor evaluate a patient for a new wheelchair. With more patients “recovering” from SCI as well as living longer, money should be thoughtfully spent as penny-wise in the short run may prove to be pound-foolish in the long run. The goal is to provide first-rate, cost-effective medical care to this disabled population.
SUMMARY
Rehabilitation of the spinal cord injured patient is complex. It is a continuum of treatment provided by specialty-trained professionals who assist the patient in learning to deal with his or her new Disability. Intervention should begin as early as the day of injury and continue throughout the patient’s lifetime. Despite being permanently disabled, patients have the potential to be as independent as they can, provided they are given appropriate tools and training. Comprehensive spinal cord injury rehabilitation can create accomplishment and independence from catastrophe and disability, offering hope and optimism to patients with spinal cord injury.
Steven D. Feinberg, M.D. and co-author
Maureen Miner, M.D.
CWCE Magazine August 1997
