Spinal Cord Injury

Abstract

Spinal cord injuries cause profound changes in virtually all physical systems and functional abilities. The spinal cord is very sensitive to injury. It does not have the ability to repair itself if damaged. Spinal cord injury is defined as damage to the spinal cord that results in loss of function such as mobility and feeding. Approximately 11,000 new spinal cord injuries occur each year. Thirteen percent of spinal cord injuries are sports related. The movie Million Dollar Baby portrays such an event. The main character, an aspiring boxer from a small town, sustains a spinal cord injury after she lands on an upside- down corner stool leaving her a quadriplegic. Quadriplegic means paralysis of four limbs. Many problems associated with spinal cord injuries bowel and bladder dysfunction, sexual dysfunction, contractures, and bed sores. Psychological barriers include depression and insecurity. Spinal cord injuries are usually onset with no preparation.

Each year 11,000 new cases of spinal cord injuries occur in the United States. Motor vehicle accidents account 44.5% and are the major cause of SCI (spinal cord injury). Falls account for 18.1% of SCI in people 45 years old and older. Thirteen percent of sports related injuries result in a spinal cord injury and most injuries occur in people ages 16-30. Diving is the leading sport in SCI (Dawodu, 2010). The average length of stay in an acute hospital resulting from a cervical injury is 54 days. Once discharged from the hospital, four percent discharge to a nursing home/ rehabilitation facility. This type of injury will need assistance with all activities of daily living, including feeding and dressing (Crewe and Krause, 2009).

The spinal cord is about 18 inches long and extends from the base of the brain, down the middle of the back, to the waist. Sensory stimuli are carried from the peripheral nerves through the spinal cord to the brain (Crewe and Krause, 2009). The spinal cord is surrounded by a protective case called the vertebrae which make up the back bone. The vertebrae are divided into seven cervical vertebrae (neck), 12 thoracic vertebrae (chest), five lower back vertebrae (lumbar), and five sacral vertebrae. Cervical nerves control the head and neck, diaphragm, biceps, wrist extenders, triceps and hands. Thoracic nerves control the chest muscles and abdominal muscles. Lumbar nerves control leg muscles, while the sacral nerves control bowel, bladder, and sexual function.

Spinal cord injuries can be divided into two types of injury, complete and incomplete. Complete means there is no function below the level of injury resulting in no sensation and no voluntary movement. Incomplete means there is some functioning below the primary level of

injury. Most incomplete injuries may be able to move one limb more than another (Eck, 2010). Cervical injuries (neck) usually result in tetraplegia formerly known as quadriplegia. According to the American Spinal Cord Injury Association, 18.5 % of SCI are complete tetraplegia. Injuries to the C-1 and C-2 can result in loss of involuntary functions including the ability to breathe, necessitating breathing aids such as mechanical ventilators.

The movie Million Dollar Baby is about a young aspiring boxer female named Maggie Fitzgerald who sustained a SCI when she fell and hit her cervical (neck) on an up-side down corner stool resulting in quadriplegia. The nature of the injury portrayed in the movie was true to form. The character received a complete injury of her C-1 and C-2 resulting in complete paralysis of all four quadrants. Her injuries resulted in damage to her spinal cord. She was unable to breathe on her own and required a ventilator machine 24 hours a day. Her mode of mobility became a wheelchair which required more than four people to help her sit up in it. Maggie later suffered from decubitus ulcers, better known as bed sores. These ulcers form when a patient is unable to shift their body to other positions. Pressure is put on that one area of contact resulting in break-down of the skin. With no circulation,