Case Management, Guardianship Support, Life Care Plan, Medical Consultation, Vocational Rehabilitation

Spinal Cord Injuries

 June 30, 2016

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

Complex medical issues impact legal cases all the time. Attorneys have their work cut out for them, especially when dealing with car or work accidents. One option to consider is the use of a Medical Legal Consulting firm to help develop your case. Medical Consultation is just one of the services offered by AdvancedRM. What can a Medical Legal Consultant do to aid an attorney working an accident case? Right up front, an understanding of pre-existing conditions and any exacerbation caused by said accident would be established.  How much deeper can we go? Gathering of information, looking at the long-term impact of the injury, and identifying future care needs and experts to document them is what we do. Many serious accidents, with repercussions just shy of death, can involve spinal cord injury or paralysis.

What is a spinal cord injury?

A spinal cord injury can be caused by a sudden, traumatic blow to the spine that fractures, dislocates, crushes, or compresses one or more of your vertebrae.  A spinal cord injury may also be the result of a gunshot or knife wound that penetrates or compresses the spinal cord. Car accidents, diving accidents, or serious falls are often the cause of a spinal cord injury. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Additional damage usually occurs over the days or weeks following the injury because of bleeding, swelling, inflammation, and fluid accumulation in and around your spinal cord.  Most injuries to the spinal cord don’t result in a complete severing of the cord. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crushes and destroy axons; extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons.  The damage to the axons may cause permanent changes in strength, sensation and other body functions below the site of the injury. A non-traumatic spinal cord injury may be caused by arthritis, cancer, inflammation, infections or disk degeneration of the spine. Some injuries will allow almost complete recovery, while others will result in paralysis.

Types of paralysis

Background knowledge will prove important to a case, but considering the weight of words in the legal profession, proper terminology and an understanding of the conditions are important. That said, what are the types of paralysis and what terminology should be used?

Quadriplegia– also known as tetraplegia, means your arms, hands, trunk, legs and pelvic organs are all affected by your spinal cord injury.

Paraplegia– affects all or part of the trunk, legs and pelvic organs.

Quadraparesis/Paraparesis– Complete paralysis may not always occur. The terms “paresis” is used to describe partial paralysis in one or all of the limbs.

What are the symptoms?

Spinal cord injuries of any kind may result in one or more of the following signs and symptoms:

  • Loss of movement
  • Loss of sensation, including the ability to feel heat, cold and touch
  • Loss of bowel or bladder control
  • Exaggerated reflex activities or spasms
  • Changes in sexual function, sexual sensitivity and fertility
  • Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord
  • Difficulty breathing, coughing or clearing secretions from your lungs

Classification of the injury

The lowest part of your spinal cord that functions normally after injury is referred to as the neurological level of your injury. The severity of the injury is often called “the completeness” and is classified as either of the following:

  • Complete– almost all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury, the injury is called complete. This terminology is becoming less common as recent studies are finding that most injuries are incomplete with the potential for some neural recovery/regeneration.
  • Incomplete– there is some motor or sensory function below the affected area, the injury is called incomplete.  There are varying degrees of incomplete injury and aggressive research is being done to determine how to promote recovery during the rehabilitation process.

What is the prognosis?

People living with a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel dysfunction, along with an increased susceptibility to respiratory and heart problems. Successful recovery depends upon how well these chronic conditions are handled day to day.  Surgery to relieve compression of the spinal tissue by surrounding bones broken or dislocated by the injury is often necessary.  Many scientists are optimistic that advances in research will someday make the complete repair of spinal cord injuries possible. Research studies are ongoing around the world. In the meantime, treatments and rehabilitation allow many people with a spinal cord injury to lead productive, independent lives.

Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities.  Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support.

What research is being done?

Scientists continue to explore and discover new ways to better understand and treat spinal cord injuries.

Current research is focused on advancing our understanding of four key principles of spinal cord repair:

  • Neuroprotection—protecting surviving nerve cells from further damage
  • Regeneration—stimulating the regrowth of axons and targeting their connections appropriately
  • Cell replacement—replacing damaged nerve or glial cells
  • Retraining CNS circuits and plasticity to restore body functions

The future of spinal cord injury

Rapid advances in technology are assisting scientist in developing new, motion-based treatments for those with spinal-cord injuries.

  • Robotic walking suits
  • Artificial limbs controlled by thought
  • Wheelchairs that go upstairs
  • Apps for a smartphone that can do anything from speech to text, to remind you to catheterize, to helping to control breathing, to calling for help if needed

Do you feel informed? AdvancedRM’s Expert staff can help to understand the medical care needed on these cases and ensure people with these injuries get the care they need. From a legal perspective, whether it’s a Life Care Plan, File Review, Attendant Care Analysis, or Home Assessment, the documentation a we provide and reports we prepare can prove essential to developing strategy. Our analysis boosts your understanding of damages, future care needs, and costs.

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