An E-Journey through the Life Cycle of Spinal Cord Injury

An E-Journey through the Life Cycle of Spinal Cord Injury

Jane Moon (University of Melbourne, Australia), Graeme K. Hart (Austin Health, Australia) and Andrew Nunn (Austin Health, Australia)
Copyright: © 2015 |Pages: 13
DOI: 10.4018/978-1-4666-5888-2.ch325
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Background

What is Spinal Cord Injury (SCI)?

Spinal Cord Injury (SCI) is a traumatic condition. The effect of SCI depends on the type of injury. There are two types of injuries: complete and incomplete. Complete injury is a severe injury where there is no voluntary function or sensation bilaterally below the level of the injury. An incomplete injury has some bodily function below the level of the injury with varying degrees of mobility and sensation. Some patients might have no movement but some sensation or vice versa (Boninger et al., 2012; Fehlings, 2013).

The level of injury is very helpful in predicting which part of the body will be affected. The motilities vary depending on the types of injury and the higher the injury toward cervical nerves, the higher will be the dependency on the medical and social support and prolonged rehabilitation (QSCIS, 2010).

The American Spinal Injury Association (ASIA) Standards (ASIA, 2013) have been widely used to assess motor function of SCI. Spinal cord injuries are divided into largely four sections: cervical (C1 to C7), thoracic (T1 to T12), lumbar (L1 to L5) and sacral nerve (Sarhan, 2012) as can be seen Figure 1.

Figure 1.

Picture of spinal cord. Source: (Bickenbach, 2013).

Table 1 describes conditions and injury sites of cervical and thoracic, as they are the more serious conditions, to give some reflection of the complexity of the condition and how it could relate to the amount of information generated as a patient experiences the effects of SCI (Fehlings, 2013; Kim, Ludwig, Vaccaro. R.A., & Chang, 2008; Lin, 2003; Merritt, Rowland, & Pedley, 2010).

Table 1.
Summary of clinical description of spinal cord injuries
     Injury Site     Condition
C-1, C-2, C-3, C-4Often on ventilation for breathing as well as pace makers
     C-5Shoulder and bicep but no wrist movement
     C-6Wrist but no hand movement
C-7 & T-1Straighten arms but little dexterity with hands and fingers
T1 to T-8Control of hands but poor trunk control
T-9 to T-12Good trunk control and good abdominal muscle control
S-1 to S-5Bowel, bladder and sexual function

Australian Institute of Health Welfare survey over period 2007-2008 showed 50-59% accounted for cervical injuries (n=127), the most common one being C4-C5. The next common neurological level was T12/L1 (n=26) of 11%, lumbar and sacral made up for remaining cases (Norton, 2010).

Key Terms in this Chapter

VDL: Victorian Data Linkage.

NEHTA: National eHealth Transition Authority.

SCI: Spinal Cord Injury.

Paraplegia: The impairment or loss of motor and/or sensory function in the thoracic, lumbar or sacral (but not cervical) segments of the spinal cord, due to damage of neural elements within the spinal canal.

Neurological level of SCI: the most caudal segment of the spinal cord with normal sensory and motor function on both sides of the body (i.e. the lowest level that has full function).

VSTORM: Victorian State Trauma Outcomes Registry.

ASCIR: Australian Spinal Cord Injury Register.

ASIA: American Spinal Injury Association.

TAC: Transport Accident Commission.

Tetraplegia: The impairment or loss of motor and/or sensory function in the cervical segments of the spinal cord due to damage of neural elements within the spinal canal.

Extent of SCI: Extent of neurological damage; can be either ‘complete’ or ‘incomplete’. Partial sensory below neurological level including sacral segment is defined as ‘incomplete injury.’ The absence of sensory and motor function below sacral segment is referred to as ‘complete injury.’

VEMD: Victorian Emergency Medical Database.

ANZICS: Australian New Zealand Intensive Care Society.

PCEHR: Personally Controlled Electronic Health Record.

VAED: Victorian Admitted Episodes Data Set.

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