Recovering from Spinal Cord Injury: Treatment Stages
People often ask me when or if there will ever be a cure for spinal cord injury. Although there are many differing opinions about this, I am confident there will be a cure in my lifetime. In the meantime, anyone with a spinal cord injury should have a long-term plan for their treatment and care.
The number of spinal cord injuries per year has remained fairly stable over the last two decades, with nearly 12,000 occurring each year mostly from sports injuries, car accidents and other forms of traumatic injury. Currently in the United States there are approximately 200,000 people are living with spinal cord injuries or spinal dysfunction. With today’s advanced medical treatments, more spinal cord injury patients survive the trauma compared to just a few decades ago. This positive shift in mortality rate underlines the great importance of initial acute treatment and follow up rehabilitation.
Treatment for spinal cord injuries can be divided into to two stages: acute and rehabilitation. The acute phase takes place immediate following the injury and is conducted at a hospital with an appropriate trauma center. During this time, the patient is immobilized to ensure that the damage to the spinal cord is minimized and any other injuries can be treated. This phase may also include surgery to reinforce the damaged area of the spine to prevent further injury. The acute phase will conclude when the patient is stabilized and ready to begin the next step towards recovery—rehabilitation therapy.
The rehabilitation phase will provide the tools necessary to begin working toward independence. This is a critical time for recovery because many of the gains the patient will make in movement happen during this time. This is why acute rehabilitation, as opposed to rehab done in sub-acute facilities, is so important after such an injury. Improvements made during this period can set the stage for the patient’s recovery afterwards.
While all spinal cord injury patients require rigorous physical and occupational therapy, the injuries and pace of recovery are unique to each person. An individualized plan should be designed to help the patient maximize their recovery. In addition, spinal cord injury patients should receive ongoing education from various disciplines as their injuries and resulting conditions are life-changing and permanent. This education should focus on coping, additional resources and the need for lifelong follow up to deal with changing needs, laying the groundwork for a lifetime of work and improvement.
Once acute rehabilitation concludes, the real work comes next as patients need to continually strive to maintain muscle mass and flexibility through exercise therapy. This can be done at outpatient rehabilitation therapy clinics or at other facilities.
Patients must work on sustaining physical integrity until there is a cure so when the time comes, they will be ready for it.
By Argy Stampas, M.D.
Director, Spinal Cord Injury Program
To read other blog post by Dr. Stampas and the rest of Burke’s doctors, visit Burke’s Rehab Insights blog.