What is a Spinal Cord Injury?
A spinal cord injury (SCI) is serious damage to the spinal cord, which often leads to loss of movement or feeling. The spinal cord is a key part of the central nervous system. It runs from the brain down the back and is protected by the bones of the spine. This bundle of nerves sends signals between the brain and the rest of the body. When it gets hurt, these signals can be blocked, causing major problems.
Types of Spinal Cord Injuries
There are two main types of spinal cord injuries: complete and incomplete.
Complete Spinal Cord Injury: In a complete SCI, the person loses all feeling and movement below the injury. This means they cannot move or feel anything below the injured area.
Incomplete Spinal Cord Injury: In an incomplete SCI, the person still has some feeling or movement below the injury. The amount of function they keep can be different for each person, with some having more movement or sensation than others.
Causes of spinal injuries
Motor vehicle accidents: These are the main cause of spinal cord injuries (SCIs), making up almost half of new SCIs each year in the United States.
Falls: Falls are the second most common cause, especially among older adults. Falls can be:
⦁ Low falls: From standing height or less
⦁ High falls: From greater heights
Acts of violence: About 12% of SCIs come from violent acts, mostly from gunshot or knife wounds.
Sports and recreation injuries: These make up about 10% of SCIs, with diving being the most common sports-related cause.
Work-related accidents: Especially in jobs involving heights or heavy machinery.
Other notable causes include:
⦁ Diving into shallow water
⦁ Electrical accidents
⦁ Severe twisting of the torso
⦁ Traffic accidents involving unprotected road users like motorcyclists, pedestrians, and cyclists
⦁ Water-related accidents, such as being hit by a wave
People most at risk for SCIs include:
⦁ Males (about 80% of traumatic SCI cases)
⦁ Young adults aged 16-30
⦁ Adults over 65 (especially for fall-related SCIs)
⦁ People engaging in risky behaviors or under the influence of alcohol
Understanding the Framework of the Spine
The spine, also known as the vertebral column or backbone, is a complex structure crucial for supporting the body and protecting the spinal cord. Here are its key parts and features:
Vertebrae:
⦁ The spine has 33 individual bones called vertebrae, stacked to form the spinal column.
⦁ The vertebrae are divided into five regions:
⦁ Cervical (neck): 7 vertebrae
⦁ Thoracic (upper back): 12 vertebrae
⦁ Lumbar (lower back): 5 vertebrae
⦁ Sacrum: 5 fused vertebrae
⦁ Coccyx (tailbone): 4-5 fused vertebrae
Spinal Cord:
The spinal cord passes through the middle of the vertebrae.
⦁ It is a long, tube-like band of tissue connecting the brain to the lower back.
⦁ The spinal cord carries nerve signals between the brain and the rest of the body.
Intervertebral Discs:
⦁ These are soft, gel-like cushions between each vertebra.
⦁ They act as shock absorbers and allow for spine flexibility.
Facet Joints:
⦁ These small joints connect the vertebrae and enable movement.
Ligaments and Muscles:
⦁ Various ligaments and muscles surround and support the spine, providing stability and enabling movement.
Spinal Nerves:
⦁ 31 pairs of spinal nerves branch off from the spinal cord through spaces between the vertebrae.
Spinal Curvature:
⦁ The spine has a natural S-shaped curve when viewed from the side, helping to distribute weight evenly.
Protective Layers:
⦁ The spinal cord is protected by three layers of tissue called meninges: dura mater, arachnoid mater, and pia mater.
The spine’s structure allows it to perform several crucial functions:
⦁ Supporting the body’s weight
⦁ Enabling movement and flexibility
⦁ Protecting the spinal cord and nerve roots
⦁ Serving as an attachment point for muscles, ligaments, and ribs
Understanding this framework is essential for diagnosing and treating various spinal conditions and injuries.
What is the Financial Impact of a Spinal Injury?
The financial impact of a spinal cord injury (SCI) can be substantial and long-lasting. Here are the key points about the costs associated with spinal cord injuries:
Initial Medical Costs:
⦁ First-year expenses can range from $350,000 to nearly $1 million, depending on the severity and location of the injury.
⦁ For high tetraplegia injuries, first-year costs can reach about $1 million.
Ongoing Annual Costs:
⦁ After the first year, annual costs range from $42,000 for incomplete motor function to $184,000 for high tetraplegia.
⦁ Patients with low tetraplegia incur about $113,000 annually, while those with paraplegia face costs of about $69,000 per year.
Lifetime Costs:
⦁ Given the chronic nature of SCIs, lifetime costs can be substantial, especially for younger patients who require care for longer periods.
Factors Affecting Costs:
⦁ Severity and location of the injury
⦁ Age at time of injury
⦁ Prognosis for recovery
⦁ Level of ongoing care needed
Types of Expenses:
⦁ Acute hospital care and initial treatment
⦁ Rehabilitation services (physical therapy, occupational therapy, etc.)
⦁ Ongoing medical care and medications
⦁ Assistive equipment (wheelchairs, braces, etc.)
⦁ Home modifications
⦁ Long-term care or in-home nursing
⦁ Mental health treatment
⦁ Travel expenses for specialized care
Lost Income:
⦁ Only 11.7% of SCI survivors are employed one year after injury, increasing to 35.2% after 20 years.
⦁ Potential loss in earning capacity can exceed $1 million over a lifetime, based on median wages.
Hidden Costs:
⦁ Travel and accommodation for treatment
⦁ Incidental expenses during hospital stays
⦁ Higher entertainment costs while in treatment
Insurance and Benefits:
⦁ Private insurance, Medicare, Medicaid, and disability benefits may cover some costs but often leave significant out-of-pocket expenses.
Legal Settlements:
⦁ Personal injury lawsuits may provide compensation to cover long-term care costs.
Can you treat spinal cord injuries ?
While spinal cord injuries cannot be fully reversed or cured, several treatment approaches can help manage symptoms, prevent complications, and promote recovery:
Emergency Care and Stabilization:
- Immediate immobilization and medical care are crucial to prevent further damage.
Surgery:
- Surgery may be needed to remove bone fragments, foreign objects, herniated disks, or fractured vertebrae compressing the spinal cord.
Medications:
- Corticosteroids like methylprednisolone can reduce inflammation and nerve cell damage if given within 8 hours of injury.
- Other medications help manage pain, muscle spasticity, and bladder/bowel control issues.
Rehabilitation Therapy:
- Physical therapy, occupational therapy, and other rehab approaches help patients regain function and independence.
Assistive Devices:
- Wheelchairs, computer adaptations, and electronic aids can help with mobility and daily activities.
Respiratory Support:
- Needed for high cervical injuries affecting breathing.
Management of Secondary Complications:
- Preventing and treating issues like pressure sores, urinary tract infections, and blood clots.
Experimental Treatments:
- Stem cell therapies, nerve cell transplants, and other novel approaches are being researched but are not yet widely available.
Psychological Support:
- Helps patients cope with the emotional and mental health impacts.
Ongoing Medical Care:
- Regular follow-ups to monitor and manage long-term health issues.
Although the spinal cord itself cannot be repaired, these treatments aim to prevent further damage, manage symptoms, and help patients adapt to any permanent disabilities. The specific treatment plan depends on the severity and location of the injury. Early, comprehensive treatment provides the best chance for maximum recovery, though the extent of recovery varies greatly between individuals.
Long-Term Effects of a Spinal Cord Injury
Spinal cord injuries (SCIs) can have significant long-term effects on a person’s physical, mental, and socioeconomic wellbeing. Here are some key long-term impacts of SCIs:
Physical Effects:
- Paralysis: Depending on the injury’s level and severity, SCIs can cause partial or complete paralysis below the injury site, resulting in paraplegia (affecting lower limbs) or tetraplegia/quadriplegia (affecting all four limbs).
- Loss of Sensation: Reduced or absent feeling in affected areas of the body.
- Chronic Pain: Many SCI survivors experience ongoing neuropathic pain.
- Spasticity: Involuntary muscle contractions and stiffness.
- Bowel and Bladder Dysfunction: Loss of control over these functions is common.
- Sexual Dysfunction: Changes in sexual function and fertility.
- Respiratory Issues: Breathing problems may persist long-term, especially for high cervical injuries.
- Cardiovascular Complications: Issues with blood pressure regulation and increased risk of deep vein thrombosis.
Medical Complications:
- Pressure Ulcers: Due to lack of sensation and mobility.
- Urinary Tract Infections: Frequent complications due to bladder management issues.
- Osteoporosis: Bone density loss due to inactivity.
- Pneumonia: Higher risk due to respiratory muscle weakness.
Mental Health Effects:
- Depression and Anxiety: Common psychological impacts of adjusting to life post-injury.
- Post-Traumatic Stress Disorder (PTSD): Especially if the injury resulted from a traumatic event.
Socioeconomic Impacts:
- Reduced Employment: Only 18% of people with SCIs are employed 1 year post-injury, increasing to 32% after 40 years.
- Financial Burden: Estimated $1.1 million in expenses in the first year, with an additional $200,000 annually thereafter.
- Lifestyle Changes: Need for assistive devices, home modifications, and potentially long-term care assistance.
- Social Relationships: Potential challenges in maintaining or forming new relationships due to physical limitations and lifestyle changes.
Long-term Health Management:
- Ongoing Medical Care: Regular check-ups, management of secondary conditions, and potential rehospitalizations.
- Rehabilitation: Continued physical therapy and occupational therapy to maintain function and independence.
- Assistive Technology: Reliance on wheelchairs, adaptive equipment, and potentially respiratory support devices.
It’s important to note that the severity and specific effects of an SCI can vary greatly depending on the injury’s level and completeness. Advances in medical care and rehabilitation techniques have improved long-term outcomes for many SCI survivors, but significant challenges often remain. Comprehensive, multidisciplinary care and support are crucial for maximizing quality of life and independence for individuals living with SCIs.
Do you need long-term care for spinal cord injuries?
Yes, long-term care is often necessary for spinal cord injuries (SCIs). Here are some key points about the long-term care needs for SCI patients:
Ongoing Rehabilitation:
- Rehabilitation is essential for maintaining mobility and function. This may include physical therapy, occupational therapy, and other forms of rehabilitation to help patients regain and maintain abilities.
Prevention and Management of Complications:
- SCI patients are at risk for various long-term complications like cardiovascular issues, sexual dysfunction, pressure sores, urinary tract infections, and respiratory problems. Ongoing care is needed to prevent and manage these.
Bladder and Bowel Management:
- SCIs often affect bladder and bowel control, requiring long-term management strategies.
Pain Management:
- Chronic pain is common in SCI patients and may require ongoing treatment.
Regular Medical Checkups:
- Patients need regular follow-up appointments to monitor their condition and address any emerging issues.
Mental Health Support:
- Counseling may be needed to help with depression and other psychological impacts of SCI.
Assistive Devices and Home Modifications:
- Patients may need ongoing support with wheelchairs, adaptive equipment, and home modifications.
Specialized Medical Care:
- SCI patients often require care from various specialists to address different aspects of their condition.
Potential for Additional Surgeries:
- Some patients may need further surgeries years after the initial injury.
Lifelong Adaptations:
- Many SCI patients need to make permanent lifestyle adjustments and require ongoing support to maintain quality of life.
How to Prove Negligence in a Spinal Cord Injury Case ?
To prove negligence in a spinal cord injury case, you need to establish the following four key elements:
1. Duty of Care:
Show that the defendant owed a duty of care to the injured party. For example, drivers must operate their vehicles safely, property owners must maintain safe premises, and doctors must provide competent medical care.
2. Breach of Duty:
Demonstrate that the defendant breached their duty of care through action or inaction. This could involve showing the defendant acted carelessly, recklessly, or failed to take reasonable precautions.
3. Causation:
Prove that the defendant’s breach of duty directly caused the spinal cord injury. This involves establishing both:
Actual Cause: The injury wouldn’t have occurred “but for” the defendant’s actions.
Proximate Cause: The injury was a foreseeable consequence of the breach.
Damages:
Show that the spinal cord injury resulted in actual damages to the victim. This can include medical expenses, lost wages, pain and suffering, and loss of quality of life.
Some key strategies to help prove these elements include:
- Gathering thorough medical documentation of the injury and prognosis.
- Collecting evidence from the accident scene (photos, videos, witness statements).
- Obtaining expert testimony from medical professionals and accident reconstruction specialists.
- Demonstrating the long-term impacts and costs associated with the spinal cord injury.
It’s important to note that spinal cord injury cases can be complex and often involve significant damages. Working with an experienced personal injury attorney who specializes in spinal cord injuries is highly recommended to build the strongest possible case.
How Spinal Cord Injury Lawyers Can Help
Customized Legal Strategy: They develop a legal plan tailored to your specific circumstances, ensuring your needs and goals are fully addressed.
Specialized Expertise in SCI Cases: Attorneys possess extensive experience and specialized knowledge in spinal cord injury cases, providing a significant advantage in your pursuit of justice.
Strong Negotiation and Litigation Skills: They are skilled in both negotiating with insurance companies and representing your case in court, vigorously advocating for your interests.
Access to Resources: They connect you with top medical professionals, therapists, and support systems to assist in your recovery.
No Upfront Costs: Lawyers operate on a contingency fee basis, so you only pay if they successfully win your case.
Also read: The Role of Job Injury attorney: In-depth Analysis
