Spinal Cord Injury (SCI) Life Care Plans

Diagnosis

Spinal Cord Injury (SCI) is an umbrella term that takes into consideration multiple kinds of injury to the spinal cord. The most accepted way to classify SCI is through the American Spinal Injury Association (ASIA) International Standards for Neurological Classification of Spinal Cord Injury. These standards use the “ASIA impairment scale” to determine the specific kind of SCI the patient suffers from. In this sense, the degree of impairment is assessed as follows:

Etiology

Just as there are multiple kinds of injury to the spinal cord, there are multiple manners of causation for resulting conditions.  These can include, but are not limited to trauma, radiation myelopathy, transverse myelitis, epidural abscess, and SCI tumors.

Functional Outcomes

Thoracic/Lumbar SCI and Cauda Equina Syndrome

Although the life of a person who suffered thoracic or lumbar SCI is changed forever, this patient has significantly better outcomes than the cervical SCI population.

Long term sequelae

* Bladder Dysfunction
* Neurogenic Bowel
* Osteoporosis
* Pulmonary Complications
* Sleep Apnea
* Pancreatitis
* Urinary Tract Infections (UTIs)
* Hypercalcemia
* Pressure Ulcers
* Sexual Dysfunction
* Infertility
* Orthostatic Hypotension
* Fracture
* Hypercalciuria
* Heterotopic Calcification
* Autonomic Dysreflexia
* Insulin Resistance
* Cholecystitis
* Depression
* Osteoporosis
* Superior Mesenteric Artery Syndrome
* Spasticity
* Joint Contractures
* Syringomyelia
* Chronic Pain
* Deep Venous Thrombosis (DVT)
* Pulmonary Embolism (PE)

Potential Costs of Care for SCI Patients

Life Expectancy in SCI

The NSCISC determined that the life expectancy of SCI patients is much lower than the able bodied population. The normal life expectancy for the able bodied population is around 79 years. For patients surviving the first year post-SCI, life expectancy ranges from 45.3 yrs for ventilator dependent patients to 78.2 yrs for those patients who only have ASIA D. These numbers depend on the age of the patient at the time of injury and the neurological level. The most common cause of death in these patients is pneumonia and sepsis.