With the frequency and seriousness of Spinal Cord Injuries (SCI), I felt that it would be beneficial to you and to our clients to provide you with an in-depth list of some common questions and answers regarding spinal cord injuries in addition to the SCI FAQ page on our main site. While we are not medical experts and you should contact your doctor if you have suffered an injury, this list will help you on your way to identifying, understanding, and dealing with SCI.
What is a SCI?
Dr. David Chen, Medical Director of the Spinal Cord Injury Rehabilitation Program at the Rehabilitation Institute of Chicago, defines a spinal cord injury saying:
When we think about spinal cord injuries, we most commonly think about a traumatic injury—someone who has been either in an auto crash, has had a fall, or perhaps a victim of an act of violence. And in all these different instances, what has happened is a tremendous amount of energy has been transmitted to the body, which is also felt by the spine and the spinal cord. So what happens is, the spinal cord is injured—like a bruising injury. That’s the most common type of spinal cord injury. If I were to go up to an individual and give him in a punch in the arm—if I hit him hard enough, they would see a bruise on their arm. Similarly, a person who has had a spinal cord injury, it’s as if their spinal cord, that structure, has taken a punch. What happens, like any part of the body that sustains that type of injury, is they develop a small amount of bleeding and bruising. And that bleeding and bruising, in addition to the swelling that occurs after an injury, can cause the nerves not to function normally, and block the signals to and from the body. That is a spinal cord injury.
What are some signs that I have a SCI?
If you have been in an accident or if you have suffered some other type of physical trauma, it is always beneficial to see a doctor right away, even if you don’t initially feel any pain, because some injuries are not noticeable immediately after an accident. However, if you are having back pains and you have not seen a doctor, or believe that the doctor may have missed something, here is an acronym, known as the “SPINAL” rule, that can be helpful in figuring out if you have a SCI.
S stands for suspicious mechanism of injury, and refers to those mechanisms which we know can result in spinal injury. This includes falls from a height of at least 1 m, an object falling onto the head, or the person’s head impacting the ground. Motor vehicle and motor bike accidents, particularly those involving high-speed, rollover or ejection are common causes, as are collisions involving pedestrians or recreational vehicles.
P stands for pain or tenderness in the spinal region, and is elicited by gently running a hand along the vertebra.
I stands for intoxication of any kind, which makes it difficult to elicit the signs and symptoms of injury but should always make one suspicious that a spinal injury may have occurred.
N stands for numbness, tingling, or loss of sensation or motor function.
A stands for any distracting or painful injury which suggests that a spinal cord injury may have occurred.
L stands for level of consciousness alteration, which reminds us once again that all head injuries are spinal injuries until proven otherwise, such that if an injury can cause an alteration or loss of consciousness, then it certainly has enough force to cause a spinal cord injury.
How serious is a SCI?
As with most injuries, the severity of the SCI varies greatly and is dependent on many variables. The resulting pain and injuries can be as simple as a sore back, or serious enough to result in the victim becoming paralyzed. As a way of gauging the seriousness of these injuries, the American Spinal Association (ASIA) recently published the sixth edition of the International Standards for Neurological and Functional Classification of Spinal Injury (ISNCSCI), an international classification of SCI. Based on neurological responses to pinprick sensations tested in each dermatome, along with the patient’s muscle strength and control, the scale is able to classify SCI into five major categories. These categories range from an A=Complete, which represents no sensory or motor function, to an E=Normal where there are few sensory or motor limitations. For a more in depth description of the categories and the process by which SCI are assessed, click the above link for the ISNCSCI.
What are the costs associated with spinal cord injuries?
The Christopher and Dana Reeve Foundation published a study conducted by The University of Alabama National Spinal Cord Injury Statistical Center and the Centers for Disease Control and Prevention. The study assessed the cost of living with varying levels of SCI.
Average Yearly Expenses
|Severity of Injury||First Year||Each Subsequent Year|
|High Tetraplegia (C1-C4)||$1,023,924||$171,808|
|Low Tetraplegia (C5-C8)||$739,874||$109,077|
|Incomplete motor function at any level||$334,170||$40,589|
Estimated Lifetime Costs by Age of Injury
|Severity of Injury||25 Years Old||50 Years Old|
|High Tetraplegia (C1-C4)||$4,53,182||$2,496,856|
|Low Tetraplegia (C5-C8)||$3,319,533||$2,041,809|
|Incomplete motor function at any level||$1,517,806||$1,071,309|
Who covers these costs?
9.7% of costs are self-paid, 23.5% of costs are covered through miscellaneous means of payment (auto insurance, charitable funds, etc.), 24.3% of costs are covered through government programs, and 42.5% of costs are covered by insurance companies or workers compensation.
What if my insurance company is unwilling to cover the cost of my injuries?
We know as well as anyone that insurance companies are less than helpful when it comes to providing you with everything you need in order to fully recover and move on with your life. If you feel like the insurance company is not working with you, or that you have done all you can and the compensation is not enough to cover your injuries, please refer to our Spinal Cord Injuries site for information of cases we handle and for information on how to contact us.
When can I return to work or to school after a spinal cord injury?
The director of the Life Center Rehabilitation Institute of Chicago, Kristine Cichowski, MS, says that the best thing you can do is to set in your mind early on that you are going to go back to school, or that you are going to go back to work. Don’t put it off and say, “I’ll think about going back to work later.” Tell yourself that you are going to, and then make a real goal as to when that will be. Finally, make a plan of how to achieve that goal.
The average length of initial hospitalization following injury in acute care units is 12 Days.
The average amount of time spent in a rehabilitation unit is 37 Days.
What are some ways that I can initially cope with SCI?
Robin Dorman, a clinical health psychologist from the Northwestern University Medical Center in Chicago, gave the following suggestions:
Take stock of all the worries, all the “what ifs” that are going through your mind … and think about, “Which ones of these can I get more information about?” Or, “Which ones of these can I take steps to solve problems?” So, if the “what if” is, “What do I do about my home?” Start to gather information about what people do about their homes. The other side can be the “what ifs” and the worries that there aren’t answers to, or that you can’t find answers to in that immediate amount of time, such as, “What is our relationship going to look like?” For these questions it’s so important to have sounding boards, to have support, to listen to what other people have done, or simply share those fears. It can be very helpful for people at that stage to start writing in a journal and to get those worries out of their heads and onto a page.
What should families of SCI victims know right away?
Just remember that your role as a caregiver and loved one is very important, and that the victim is in need of your love and support more than anything. SCI victims need to know that you will still be there for them throughout their struggles and that their injuries will not result in them losing your companionship as well.