Spinal Cord Injury Causes
A spinal cord injury (SCI) is damage or trauma to the spinal cord which results in a loss or impaired function causing reduced mobility or feeling. Typically the damage is caused by a trauma or a disease.
A loss of function may occur even without severance of the spinal cord. Frequently, the spinal cord remains intact, but the cellular damage to it results in loss of functioning. Typically, a SCI affects the chest and legs and may result in paraplegia. The effects may vary depending on the type and level of the injury:
- Complete injury: diagnosed where there is no function below the level of the injury; no sensation and no voluntary movement; and it affects equally both sides of the body;
- Incomplete injury: there is some functioning below the primary level of the injury. You may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body that the other.
A paralysis may be:
- Paraplegia: loss of movement and sensation of the lower part of the body. Usually, both legs and internal organs below the level of injury would be affected;
- Tetraplegia (aka Quadriplegia): both legs and arms are affected.
The spinal cord is a collection of nerves that spreads from the bottom of the brain down the back. 31 pairs of nerves connect the spinal cord to your arms, legs, chest and abdomen. Thus, your brain is allowed to command your muscles and control the movement of your limbs. These nerves also control the function of your organs including your heart, lungs, bowels and bladder. Furthermore, nerves run from your limbs back to the spinal cord transmitting information to the brain in relation to touch, pain, temperature and position. The spinal cord is situated in the spinal canal which is surrounded by bones in your neck and back (vertebrae), which constitute the back bone. The vertebrae's function is to protect the spinal cord from injury.
The spinal cord may be divided in four major sections: Cervical, Thoracic, Lumbar and Sacral.
A C6 injury would result in tetraplegia: partial paralysis of hands and arms as well as lower body.
A T4 injury would result in paraplegia: paralysis below the chest.
A L1 Injury would result in paraplegia: paralysis below the waist.
TREATMENT OF SCI
Although a SCI is not as common as a lot of other injuries, its physical and psychological consequences are devastating. Very few people experience full recovery following a spinal cord injury. A substantial proportion of SCIs result in neurologically complete and tetraplegic deficits. Lifetime costs of managing SCI and related secondary conditions are astounding and pose a significant burden on individuals with spinal cord injury, their families, and society.
To begin treating a SCI the spine must be restrained and inflammation controlled. Thus, further damage is prevented. The treatment itself varies depending on the specifics of the injury.
A lot of cases of SCI are treated with surgery. A surgery's aims are:
- To relieve pressure on the spinal cord: this could involve removing parts of the broken vertebrae which are compressing the spinal cord. In cases where the spinal cord is being compressed by tumour, infection or severe arthritis, a surgery is performed to diminish the extent of compression.
- To stabilize the spine: if the vertebrae are weakened from fracture, tumor or infection, they may not be capable of supporting the normal weight from the body and protecting the spinal cord. A combination of meta screws, rods and plates may be necessary to aid in holding the vertebrae together and stabilize them until the bones heal.
The effects of a spinal cord injury may vary greatly depending on the level of the injury. Initially, a diagnosis of the level of the injury may be given by the medical professionals, although, this may change slightly in the first few weeks as the trauma settles. Furthermore, recovery, rehabilitation and aging differ from individual to individual.
There are a number of possible complications in relation to a SCI. These may require specific treatment and include:
- Pressure sores and blood clots: pressure and discomfort cannot be felt in the paralysed areas of the body. Therefore, the person is unable to relieve this themselves. Consequently, the blood supply to the skin decreases and pressure sores/ulcers may occur. To prevent this, the patient must be repositioned by nursing staff every two or three hours. Furthermore, physiotherapy should be carried out on the paralysed limbs in order to prevent the joints from becoming stiff or deformed.
- Bowel incontinence (inability to control bowel movements): bowel sensation is lost, along with the ability to empty it. This will initially be carried out with the assistance of the nursing staff. Long term bowel management will be taught during rehabilitation.
- Chronic pain: phantom pain may be experienced at the level or just below the level of injury.
- Infections in the lungs (pneumonia);
- Muscle spasms: involuntary, uncontrolled movements, actions or contractions may be experienced by people with a level of injury T12 or above within the first few months following a SCI. These muscle contractions may help strengthen and grow the muscles thus enabling them to cause resistance when being moved. Spasms may be controlled by medication.
- Urinary tract infections or urinary incontinence (inability to control the flow of urine): bladder sensation is lost, along with the ability to empty it. This will initially be carried out with the assistance of the nursing staff. Long term bladder management will be taught during rehabilitation.
- Low blood pressure: it is typical and may cause dizziness when getting out of bed into a wheelchair.
- Loss of temperature regulation: the body's system for temperature regulation may be affected in the following ways:
- In cold weather, the body's inability to shiver prevents it from regaining temperature naturally and may result in hypothermia (reduction in body temperature);
- In hot weather, the body's inability to sweat below the level of injury results in it overheating (hyperthermia).
- Autonomic Dysreflexia (AD): a sudden and potentially fatal surge of blood pressure which is typically caused by acute pain or a harmful trigger. This may affect people with a T6 injury or a higher level spinal cord injury. This triggers hypertension (very high blood pressure) and may lead to a stroke and even death. An AD should always be treated as an emergency! Symptoms of an AD include pulsating headache, rosy skin and extreme sweating. These symptoms should subside as soon as the stimulus is removed.
- Sexual dysfunction: men may not be able to get an erection. Although this ability may partly return within a few months, this is typically only possible in the level of injury is at T12 or above. Women may not have their periods for a while, although they will normally reoccur and stabilise within a few months. Loss of vaginal sensation and lubrication is also possible.
Where you were treated following your SCI has a considerable effect on your health and your perception of health.
Typically, a SCI requires substantial physical therapy and rehabilitation, especially if your injury interferes with your day-to-day activities.
Rehabilitation is the process of teaching you to live with your disability in your own environment. This learning experience is a dynamic process which starts at the moment of injury and continues for the rest of your life. Learning to live with a disability may be a lengthy and often frustrating process.
We fully appreciate the importance of rehabilitation and on-going physiotherapy for you or your loved one. The main purpose of rehabilitation is prevention of secondary complications, maximisation of physical functioning, and reintegration into the community. We work with SCI medical experts to ensure correct levels of rehabilitation are undertaken. A rehabilitation programme is most effective when it encompasses multiple disciplines performed by a team of a number of specialists such as: physical therapists, occupational therapists, rehabilitation nurses, psychologists, speech-language pathologists, and case managers. Such a programme covers all aspects of your new needs including personal care, bladder and bowel management, wound care, hydrotherapy, psychological counselling, teaching activities of daily living and treadmill therapy. We will ensure that you are able to play an active part in making informed decisions regarding all aspects of your rehabilitation.
The emotional impact of a spinal cord injury on an individual may vary. People typically experience a range of emotions such as: frustration, anger, guilt, depression, self-doubt, loss of self-worth and confidence. These are only natural reactions to a life-changing injury. You may find it helpful to talk to someone such as another person with a SCI, a medical professional or a legal SCI specialist.
You will probably spend between four and nine months in the hospital. Typically, at least initially, you will be very dependent on others. The main nursing objectives in providing care for people with SCI include:
- Identifying problems and preventing deterioration;
- Preventing secondary complications;
- Facilitating maximal functional recovery;
- Supporting you and your family in learning to adjust to the your changed physical status;
- Awareness of the effect of the injury on your perception of self-worth;
- Empowering you;
- Educating you to take control of your life.
Physiotherapy assessment and treatment should be carried out as soon as possible after your injury. Care of the chest and paralysed limbs is of crucial importance during the early acute stage. A physiotherapy programme may involve the following:
- Respiratory management: you should receive prophylactic chest treatment which may include deep breathing exercises, percussion and coughing, assisted if necessary.
- Passive movements: all paralysed limbs should be moved passively every day to maintain a full range of movement.
- Mobilisation into a wheelchair: relief of pressure at some regions is essential to prevent the development of pressure sores.
- Physical rehabilitation therapy:
- Familiarity with the wheelchair;
- Relearning the ability to balance;
- Strengthening non-paralysed muscles;
- Learning to transfer from wheelchair to bed, toilet, bath, floor, easy chair, and car;
- Learning advanced wheelchair skills;
- Regular standing in order to help preventing contractures, reducing spasticity, and minimising osteoporosis.
- Recreational activities encourage balance, strength, and fitness, and may help with your reintegration into society.
Occupational therapy aims to assist you in reaching the maximum level of functional physical and psychological independence possible. This will depend on the extent of your impairment, your home, personal, and social situation. An occupational therapist's goal is to help you in overcoming your difficulties. This may often be done by using alternative methods and equipment to assist you with personal care, domestic tasks, and communication. Moreover, your occupational therapist will be able to advise you on home modifications, mobility including wheelchairs, driving and transport, returning to your employment or education, and the pursuit of leisure activities and hobbies.
HOW DOES A SCI AFFECT YOU?
A spinal injury suffered by you or a loved one will have severe consequences on your whole life. Previously routine tasks in your day-to-day life turn out to be extremely difficult and sometimes even impossible. Suffering a spinal injury has a tremendous effect on all aspects of the life of the victim and their family. This affects not only your social life, employment, education, family life and relationships, but, moreover, even previously routine tasks such as showering, eating, going to the toilet, going to the shop. Receiving the necessary help and support in order to adapt your life to the new circumstances may be extremely costly which only increases the stress one suffers from the injury by adding financial hardship to the list of hurdles to overcome.
EXPERT LEGAL REPRESENTATION:
Spinal injury cases are usually extremely complex. Thus, they require a particular expertise and experience from the solicitors who undertake such claims. Compensation Solicitors Online is a well-established specialist in the area of SCI claims and our professionals are fully equipped to lead you all the way to the compensation which you deserve in this difficult time of your life. Furthermore, we understand that you need more than just money: we will advise you and support you all the way through your claim.
We can simplify the complexity of making a spinal injury claim and summarise it in three steps:
ESTABLISHING LIABILITY (WHO WAS RESPONSIBLE FOR THE ACCIDENT):
The first step is to show who was at fault for the accident to take place and to what degree. This is not necessarily straightforward and sometimes contributory negligence may be found (the victim has contributed to some extent to the harm that s/he has suffered). However, this concept only plays a role in calculating the compensation value and does not affect the establishing of liability.
SHOWING CAUSATION (SHOWING THAT THE ACCIDENT CAUSED THE SPINAL INJURY):
Once a degree of liability has been established, it must be demonstrated that the resulting SCI has been caused by the accident, and not by a previous medical condition or another accident, for example.
CALCULATING THE QUANTUM (ESTABLISHING THE APPROPRIATE AMOUNT OF COMPENSATION):
The compensation in such cases will have the purpose of attempting to put the claimant in the position s/he has been in before the accident. It is our specialist solicitors' job to liaise with medical and other experts in order to prepare a Schedule of Loss, setting out the solutions and costs to all problems which the claimant has or may have in the future, as a result of the accident.
Our expert solicitors have experience in achieving the best results in all the three steps of the process, thus ensuring that you get the best compensation which you deserve.
It is our priority to ensure that you get the right medical/rehabilitative treatment, as well as expert advice on nursing care and disability aids as quickly as possible. This can make a real difference in your life.
It is our goal to obtain interim payments during your claim to cover the cost of early private rehabilitation and support services. Early rehabilitation may make a crucial difference in your long term recovery. These payments can help cover costs such as rehabilitation, specialist equipment and medical treatment. Such payments may only be awarded if liability is accepted by the defendant. Therefore, it is essential that you have our expert team on your side to prove liability by the defendant as early as possible in order for interim payments to be arranged and your immediate care needs to be met.
There are a variety of funding options open to you. We will discuss these options with you in more detail and where appropriate represent you on a no win no fee basis (also known as a Conditional Fee Agreement).
A spinal injury claim can take years rather than months to finalise. The specialist solicitors from Compensation Solicitors Online always aim to establish a balance between the need to allow time for medical experts to examine and evaluate the full extent of the injury, and the client's interest of concluding the claim and moving on with their life.
Generally, personal injury claims have a three year time limit i.e. court proceedings have to be issued at least one day before the third anniversary of the accident , otherwise they will be time barred and you will no longer be able to pursue your claim. (There are a few exceptions to this rule and the court does have some very limited discretion to extend the various time limits). You can still pursue a claim for personal injury after the third anniversary of the accident, you just have to make sure court proceedings have been issued before that third anniversary in order to do so. We will be happy to discuss this further with you.
If you are a minor at the time of the accident, i.e. under 18 then the 3 year limitation date period starts to run after you have turned 18. Furthermore, there also a complicated set of rules that allows the 3 years limitation date period to run from the date of knowledge of the incident/accident. These rules normally apply to clinical/medical negligence cases or industrial disease claims, where they may be a long latency period between the incident giving rise to your claim and you first suffering any symptoms and becoming aware of it. The rules on this are technical and we will, once again, be happy to discuss this in detail with you.
There are two parts to any compensation claim, consisting of two types of damages:
General damages are calculated as a part of the compensation based on the type of injury and are designed to compensate for pain and suffering and the impact on the claimant's enjoyment of life.
Special damages are the more variable part of the compensation and depend on individual circumstances. The claimant may be able to recover:
- Expenses relating to the cost of living with any disability;
- Expenses to cover services provided by other people;
- Increased accommodation costs;
- Loss of earnings;
- Medical expenses;
- The cost of buying in care.
Establishing the level of special damages to be paid is a crucial part of a compensation claim. Compensation Solicitors Online have experience in compensation claims in cases of spinal injury.
MAKE A CLAIM
If you would like to speak directly to a solicitor for a free and without obligation chat about your case call us on 0203 380 9406 or send us your details, with brief outline, by email to [email protected] and you will receive a prompt response.
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