Spinal cord injury (SCI) is a complex and life-changing disease. It encompasses damage to the spinal cord from traumatic or nontraumatic causes, ranging from a child born with spina bifida to an elderly person developing SCI from osteoporosis.
Medical Consequences & Acute Management
Spinal cord injury has significant medical consequences, leaving the individual paralyzed below the level of the injury (tetraplegic or paraplegic). Acute management is challenging and involves:
- Prehospital Care: Evacuation, first aid, and safe transfer.
- Emergency Management: Comprehensive evaluation and stabilization of fractures (conservative or surgical).
- Rehabilitation: Specialized centers reduce complications and re-hospitalization rates compared to non-specialized centers.
Rehabilitation & Independence
The highest priority for a person with SCI is often to achieve good control of bladder and bowel function to prevent social embarrassment. Regular physiotherapy and occupational therapy help maximize function.
A Multidisciplinary Approach
Managing SCI requires a team effort beyond just doctors and nurses:
- Psychologists: To handle depression, which can decrease recovery rates.
- Urologists/Sexual Counselors: To address reproductive and sexual health.
- Assistive Technology (AT) Specialists: For tailor-made wheelchairs and home modifications.
- Social Services: To help with employment rights and education.
Psychological & Social Impact
SCI has a profound impact on mental health. The incidence of anxiety disorders reaches up to 25%, and depressive disorders up to 40%. Post-traumatic stress disorder (PTSD) ranges from 10 to 40%. Sleep disturbances are also very common.
Socially, negative attitudes and misconceptions lead to exclusion. Children with SCI are less likely to start school, and adults face employment challenges.
Impact on the Family
Family members often feel as frightened and overwhelmed as the patient. It takes months or years to adjust to changes in roles, finances, and priorities. In many cases, family members become the primary caregivers, which can lead to burnout and strain personal relationships.
Relationship Strain: Statistics show 42% of males with SCI are not satisfied with their sex lives, and 34% are dissatisfied with partner relationships. Caregiver burnout is a significant factor in relationship breakdowns post-injury.
Complications & Prevention
People with SCI are at risk for:
- Recurrent Urinary Tract Infections (UTIs)
- Pressure Sores (Bedsores)
- Deep Vein Thrombosis (DVT)
- Osteoporosis & Sepsis
Constant risk leads to insecurity and higher treatment costs. Awareness is key to prevention.
Conclusion: A Call for Awareness
There is a need for special awareness programs. Spinal cord injury is both a public health and human rights challenge. With the right policies, healthcare access, and assistive devices, a person with SCI can live, thrive, and contribute to the community.
They are entitled to the same human rights and respect as all other people.