Spinal cord injury (SCI)

Introduction

 Spinal cord injury (SCI) is an insult to the

spinal cord resulting in a change, either
temporary or permanent, in its normal motor,
sensory, or autonomic function.
 “the vibrant active and well-educated people
in our country”
 Brief History

Edwin Smith Papyrus

earliest of the person with spinal cord injury
(1700 BC )
During the 1940s, specialized centers were
developed for the person with SCI.
Guttmann in England and Munro in United
States were the pioneers in their respective
countries. These units were develop to
eliminate the piecemeal care
Etiology

 Spinal cord injuries occur when blunt physical

force damages the vertebrae, ligaments, or
disks of the spinal column, causing bruising,
crushing, or tearing of spinal cord tissue, and
when the spinal cord is penetrated (eg, by a
gunshot or a knife wound).
Definition of Terms

 * Tetraplegia (replaces the term quadriplegia)

- Injury to the spinal cord in the cervical
region, with associated loss of muscle
strength in all 4 extremities
 * Paraplegia - Injury in the spinal cord in
the thoracic, lumbar, or sacral segments,
including the cauda equina and conus
medullaris
 EPIDEMIOLOGY
Causes Bradom Delisa
motor vehicle accident 45.4% 48%
acts of violence 14.6% 15%
Sports 16.3% 14%
Falls 16.8% 21%
Age Goups 25-44 year old (26 y/o) 16-30 years of age
Males vs Female 2.4:1 to 4:1 80% are male
White vs. non-white 8:1 (urban ratio 3:1)

Prevalence 525 per 1 million, or 128941
persons, to 1124 cases
per million, or 276,057
persons. The most recent
survey estimated 721 per
1 million or 176,965
persons in 1998. Less
than 5000 are estimated
Incidence 29.4tocases per 1 million to 50
be institutionalized.
cases per million
500- 900 per million. Thus,
the national incidence
varies between 7,000 to
10,000 , the prevalence of
150,000-200,000.
55 per million person per year
with 35 per million per
year surviving long
enough to be hospitalized.
EPIDEMIOLOGY
 Quadriplegia -55%
 paraplegia -45%
 Other causes of SCI include the following:
 * Vascular disorders
 * Tumors
 * Infectious conditions
 * Spondylosis
 * Vertebral fractures secondary to osteoporosis
 * Developmental disorders
 * Cancer
Other Factors
 Race
 Sex
 Age
 Associated injuries
 Marital status
 Level and type of injury
 Substance abuse
 Season
 Educational status
 Employment
Life expectancy
 10-20% of patients who have sustained an SCI do
not survive to reach acute hospitalization, while
about 3% of patients die during acute hospitalization
 People 20 years have a life expectancy of
approximately 33 years (patients with tetraplegia),
39 years (patients with low tetraplegia), or 44 years
(patients with paraplegia).
 Individuals aged 60 years at the time of injury have
a life expectancy of approximately 7 years (patients
with tetraplegia), 9 years (patients with low
tetraplegia), and 13 years (patients with paraplegia).
 The annual death rate for patients with acute SCI is
750-1000 deaths per year in the United States.
Leading cause of death
 pneumonia and other respiratory conditions,
followed by heart disease, subsequent trauma, and
septicemia. Suicide and alcohol-related deaths
are also major causes of death in patients with SCI.
In persons with SCI, the Among patients with
incomplete paraplegia, the leading causes of death
are cancer and suicide (1:1 ratio), while among
persons with complete suicide rate is higher
among individuals who are younger than 25
years.
 paraplegia, the leading cause of death is suicide,
followed by heart disease.