Report details plethora of serious health problems faced by spinal cord injury patients

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Paralysis is just one of the many serious health problems faced by patients who suffer spinal cord injuries, according to a report according to a report published on spinal cord injury published in Current Neurology and Neuroscience Reports.

Spinal cord patients are at higher risk for cardiovascular disease; pneumonia; life-threatening blood clots; bladder, bowel and sexual dysfunction; constipation and other gastrointestinal problems; pressure ulcers; and chronic pain.

As many as 94% of spinal cord patients were observed to suffer chronic pain. “It typically occurs within the first year after injury but decreases in intensity and frequency with time,” authors Rochelle Sweis and José Biller, Loyola Medicine, Chicago, USA, wrote. “It affects patients emotionally and interferes with activities of daily living.”

The most common causes of spinal cord injuries are motor vehicle accidents (46%), falls (22%), violence (16%) and sports injuries (12%). Alcohol intoxication plays a role in 25% of all spinal cord injuries.

Eighty per cent of spinal cord injuries occur in males aged 15 to 35. Fifty-three% of spinal cord injury patients are left tetraplegic and 42% are left paraplegic.

It costs between US$320,000 and US$985,000 to treat a spinal cord injury patient the first year and as much as US$5 million during the patient’s lifetime.

Mortality is highest during the first year after injury and among patients with more severe injuries. Life expectancy has not improved during the past 30 years.

The most common systemic complications following spinal cord injuries are pneumonia and other pulmonary problems. Cardiovascular disease is the most common cause of death. The degree of cardiovascular dysfunction is directly related to the severity of the injury.

Spinal cord patients are at risk for life threatening blood clots called deep vein thrombosis and pulmonary embolism. Deep vein thrombosis occurs in 47 to 90% and pulmonary embolism in 20 to 50% of spinal cord patients.

Pressure ulcers also are common. They can be avoided by position turns ever two hours, air mattresses and periodic weight shifting while sitting.

Life expectancy depends on the severity of the injury, where on the spine the injury occurs and age. Life expectancy after injury ranges from 1.5 years for a ventilator-dependent patient older than 60 to 52.6 years for a 20-year-old patient with preserved motor function.

Among patients who are not completely paralyzed, 80% can stand by 12 months and 50% walk out of the hospital by 12 months, with improvements continuing for two years after injury.

New treatments for spinal cord injury, including stem cells, gene therapy and electrical stimulation, are being studied. “The hope is that these options can someday restore some function for patients,” Sweis and Biller wrote.

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