Serious Health Problems with Spinal Cord Injuries | Loyola Medicine
Thursday, February 16, 2017

Spinal Cord Injury Patients Face Many Serious Health Problems Besides Paralysis

MAYWOOD, IL –  Paralysis is just one of the many serious health problems faced by patients who suffer spinal cord injuries.

Spinal cord patients also are at higher risk for cardiovascular disease; pneumonia; life-threatening blood clots; bladder, bowel and sexual dysfunction; constipation and other gastrointestinal problems; pressure ulcers; and chronic pain, according to a report published in the journal Current Neurology and Neuroscience Reports.

The article, “Systemic Complications of Spinal Cord Injury,” is written by Loyola Medicine neurologists Rochelle Sweis, DO, and José Biller, MD. Dr. Sweis is an assistant professor and Dr. Biller is professor and chair in the department of neurology of Loyola University Chicago Stritch School of Medicine.

As many as 94 percent of spinal cord patients suffer chronic pain.

“It typically occurs within the first year after injury but decreases in intensity and frequency with time,” Drs. Sweis and Biller wrote. “It affects patients emotionally and interferes with activities of daily living.”

The most common causes of spinal cord injuries are motor vehicle accidents (46 percent), falls (22 percent), violence (16 percent) and sports injuries (12 percent). Alcohol intoxication plays a role in 25 percent of all spinal cord injuries.

Eighty percent of spinal cord injuries occur in males aged 15 to 35. Fifty-three percent of spinal cord injury patients are left tetraplegic (partial or total paralysis of the arms, legs and torso) and 42 percent are left paraplegic (partial or total paralysis of the legs).

It costs between $320,000 and $985,000 to treat a spinal cord injury patient the first year and as much as $5 million during the patient’s lifetime.

Mortality is highest during the first year after injury and among patients with more severe injuries. Life expectancy has not improved during the past 30 years.

The most common systemic complications following spinal cord injuries are pneumonia and other pulmonary problems. Cardiovascular disease is the most common cause of death. The degree of cardiovascular dysfunction is directly related to the severity of the injury.

Spinal cord patients are at risk for life threatening blood clots called deep vein thrombosis (usually in the legs) and pulmonary embolism (lungs). Deep vein thrombosis occurs in 47 to 90 percent and pulmonary embolism in 20 to 50 percent of spinal cord patients.

Pressure ulcers also are common. They can be avoided by position turns ever two hours, air mattresses and periodic weight shifting while sitting.

Life expectancy depends on the severity of the injury, where on the spine the injury occurs and age. Life expectancy after injury ranges from 1.5 years for a ventilator-dependent patient older than 60 to 52.6 years for a 20-year-old patient with preserved motor function.

Fatal complications of spinal cord injury include blood clots and sepsis due to pneumonia, urinary infections or pressure sores.

The good news is that among patients who are not completely paralyzed, 80 percent stand by 12 months and 50 percent walk out of the hospital by 12 months, with improvements continuing for two years after injury.

New treatments for spinal cord injury, including stem cells, gene therapy and electrical stimulation, are being studied. “The hope is that these options can some day restore some function for patients,” Drs. Sweis and Biller wrote.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.