Spinal Cord Injury

A Spinal Cord Injury (SCI) will affect every function of the body below the level of the lesion caused by the trauma.

Because the effects of an SCI are likely to be so widespread (and may in addition have psychological consequences), it is critical that a holistic (whole-person) approach to treatment, rehabilitation and care is adopted from the early hours or days of injury. Bed rest is generally required but bed rest without specialist care may lead to pressure sores and many other complications that can take months to heal. The short and long term reaction of spinal cord injured people to drugs may be greatly exaggerated.
The principles of management and the treatment of patients with spinal injuries differ from those for the non-paralysed population.

The United Kingdom is a world leader in the immediate treatment, rehabilitation and long term support of those with SCI and UK specialists have wide knowledge to share with those in other countries. But those with knowledge can still learn from the experiences in other less advanced countries. SPIRIT’s mission is to identify the best practices and spread the word worldwide.

Management systems for patients with spinal injuries vary a great deal between and within countries. In countries where there is no specialist SCI treatment infrastructure, death due to complications is the almost inevitable outcome, in hospital or shortly after discharge.

There is no single skill that can transform poor care into efficient modern treatment.

Every stage requires expert management and poses special challenges:

Stage One

Acute care requires urgent decisions about life saving treatment of the injured spine and about the many problems that accompany paralysis: such as bladder dysfunction, bowel dysfunction, circulatory problems including death from cardiac arrest , respiratory problems, and infections due to immune suppression.

Stage Two

The lack of sensation below the level of lesion in a paralysed person adds another dimension to the difficulties encountered in the diagnosis and treatment and management. Special expertise in dealing with impaired functioning of the various systems of the body associated with loss of feeling is paramount for effective treatment of complications..

Stage Three

Bed rest is generally required but bed rest without specialist care may lead to pressure sores and many other complications that can take months to heal. The short and long term reaction of spinal cord injured people to drugs may be greatly exaggerated. 

Stage Four

Spinal cord injury does not just affect one physically. Input from an experienced clinical psychologist Health Care Professionals familiar with the psychological impact of the paralysis on the patient and the family members is vital to support the spinal cord injured person on the emotional journey of adjustment following their injury.  A clinical psychologist is an important member of the treating team.

Stage Five

Rehabilitation of all systems of the body affected by paralysis is key to achieving maximum potential. Family, friends and relatives of the injured person need support to. If successful reintegration into the community, family environment and workplace is to be achieved a spinal cord injured person needs a support network in place and one in which their care and emotional support needs can be met. Peer support is paramount in reducing anxiety and encouraging participation

Stage Six

Lifelong care is required after spinal cord injury. Problems may be as varied as dealing with fractures, bladder or kidney stones or facilitating parenthood. Specialist SCI centres are able to treat educate, advise and support to prevent the long term complications of spinal cord injury.

Stage Seven

Treatment of patients with SCI by inexperienced or unqualified staff is not only medically inappropriate; it also wastes resources. Unnecessary complications or poorly managed complications may develop which then require long periods of hospital treatment.