1. Spinal Cord Injuries

2.  There are an estimated 10,000 to 12,000 spinal cord injuries every year in the United States.  The cost of managing the care of spinal cord injury patients approaches $4 billion each year. (About $3 million dollars per patient) Source: Facts and Figures at a Glance, May 2001. National Spinal Cord Injury Statistical CenterNational Spinal Cord Injury Statistical Center Information from the National institute of Health and Dr. Ann Parr M.D

3. Who are the most commonly affected ?  Risk factors include:  Participating in risky physical activities  Not wearing protective gear.  Diving into shallow water  Source: Facts and Figures at a Glance, May 2001. National Spinal Cord Injury Statistical CenterNational Spinal Cord Injury Statistical Center

4. Facts and Figures About Causes of Spinal Cord Injury  38.5% car accidents.  24.5% violent encounters (involving guns and knifes.  17%sporting accidents  20%falls, and work-related accidents.  55% of all spinal cord injury victims are between 16 and 30 years old.  80% of spinal cord injury patients are men Source: Facts and Figures at a Glance, May 2001. National Spinal Cord Injury Statistical Center.National Spinal Cord Injury Statistical Center

5. Spinal Nerves  Cervical nerves: Controls back of the head, neck/shoulders, arms/ hands, and the diaphragm.  Thoracic nerves Control signals to the chest muscles, some muscles of the back, and parts of the abdomen.  Lumbar nerves Control signals the lower parts of the abdomen/ back, buttocks, some parts of the external genital organs, and parts of the leg.  Sacral nerves Control signals to the legs, the feet, most of the external genital organs, and the area around the anus.  Information from the National Institute of Health.

6. Spinal Cord  Full Size at birth.  In adulthood the spinal cord only fills the upper two thirds.  Lumbar region the spinal cord breaks off into the, Cauda equina, or horse tail.  Information from the National institute of Health and Dr. Ann Parr M.D

7. The spinal cord Pictures from ADAM

8. What are the Characteristics of spinal Cord injuries?  Spinal cord trauma is damage to the spinal cord.  It may result from direct injury  indirect from disease of the surrounding bones, tissues or blood vessels.

9. Spinal Cord Injuries.  The majority of spinal cord injuries are due to the crushing of the spinal cord. Very rarely to almost never is there a severing of the cord.

10. Classification of Spinal Cord Injuries  ASIA (American Spinal Injury Association) Impairment Scale* Classification Description  A Complete: no motor or sensory function is preserved below the level of injury, including the sacral segments S4-S5  B Incomplete: sensory, but not motor. May have some S4 – S5

11. Classification of Spinal Cord Injuries  C Incomplete: motor function is preserved below the neurologic level, however, more than half of key muscles below the neurologic level have a muscle that are not strong enough to move against gravity.  D Incomplete: motor function is preserved below the neurologic level, and at least half of key muscles below the neurologic level have a muscles or joints that can be moved against gravity.  E Normal: motor and sensory functions are normal  Used with permission of the American Spinal Injury Association.

12. Trauma can lead to complete and incomplete spinal cord injury?  Complete spinal: cord injury, the cord can't relay messages below the level of the injury. As a result, you are paralyzed. below the level of injury. Incomplete injury: you have some movement and sensation below the injury. Picture from Sci. recovery.org Incomplete Injury

13. What are the chances of regaining feeling and mobility after a spinal cord injury? According to Dr. Parr, only about 3% of those with complete spinal cord injuries will have some feeling.  Incomplete Injuries will gain more.  Both of these need to receive Physical Therapy for muscles condition as well as using abilities.

14. Discribe the the strategies being used to develop treatments and or cures?  Steroids drug such as methylprednisolone began in the 1960’s  Can reduce damage to nerve cells if given early enough after injury has given doctors an additional treatment option.  Used to Reduce the swelling around the damaged area.

15. What type of Newer treatment are given to the patients? Hypothermia: This is now in a clinical trial. relieves swelling from the primary injury. Reduces toxins produced by secondary injuries. These toxins can kill and damage neurons after the time of the injury. Functional Electrical Stimulation: Axons will regenerate in an electrical field toward the flow of the electrons. Stem Cell Transplants: Using adult stem cells to from the patient to build new nervous tissue. Information courtesy of Dr. Ann Parr M.D. University of Minnesota.

16. Functional Electrical Stimulation

17. New Research Continued…  The use of all of these three Techniques when used together may have the best results. As they may reduce any problems caused by scars on the glia.

18. Problems Patients Have due to injury  Autonomic dysreflexia: Can not sense autonomic reponses.  Pain: 30% have cronic pain  Reproductive and sexual function: Production of sperm as well as the mobility of the sperm.  Pressure sores (or pressure ulcers)