Sci

Spinal cord injury (SCI)

Introduction 

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Spinal cord injury (SCI) is an insult to the spinal cord resulting in a change, either temporary or permanent, in its normal motor, sensory, or autonomic function. “the vibrant active and well-educated people in our country”

Brief History Edwin Smith Papyrus earliest of the person with spinal cord injury (1700 BC ) During the 1940s, specialized centers were developed for the person with SCI. Guttmann in England and Munro in United States were the pioneers in their respective countries. These units were develop to eliminate the piecemeal care 

Etiology 

Spinal cord injuries occur when blunt physical force damages the vertebrae, ligaments, or disks of the spinal column, causing bruising, crushing, or tearing of spinal cord tissue, and when the spinal cord is penetrated (eg, by a gunshot or a knife wound).

Definition of Terms 

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* Tetraplegia (replaces the term quadriplegia) - Injury to the spinal cord in the cervical region, with associated loss of muscle strength in all 4 extremities * Paraplegia - Injury in the spinal cord in the thoracic, lumbar, or sacral segments, including the cauda equina and conus medullaris

EPIDEMIOLOGY Causes

Bradom

Delisa

motor vehicle accident

45.4%

48%

acts of violence

14.6%

15%

Sports

16.3%

14%

Falls

16.8%

21%

25-44 year old (26 y/o)

16-30 years of age

2.4:1 to 4:1

80% are male

Age Goups Males vs Female White vs. non-white Prevalence

Incidence

8:1 (urban ratio 3:1) 525 per 1 million, or 128941 persons, to 1124 cases per million, or 276,057 persons. The most recent survey estimated 721 per 1 million or 176,965 persons in 1998. Less than 5000 are estimated 29.4tocases per 1 million to 50 be institutionalized. cases per million

500- 900 per million. Thus, the national incidence varies between 7,000 to 10,000 , the prevalence of 150,000-200,000.

55 per million person per year with 35 per million per year surviving long enough to be hospitalized.

EPIDEMIOLOGY          

Quadriplegia -55% paraplegia -45% Other causes of SCI include the following: * Vascular disorders * Tumors * Infectious conditions * Spondylosis * Vertebral fractures secondary to osteoporosis * Developmental disorders * Cancer

Other Factors          

Race Sex Age Associated injuries Marital status Level and type of injury Substance abuse Season Educational status Employment

Life expectancy 

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10-20% of patients who have sustained an SCI do not survive to reach acute hospitalization, while about 3% of patients die during acute hospitalization People 20 years have a life expectancy of approximately 33 years (patients with tetraplegia), 39 years (patients with low tetraplegia), or 44 years (patients with paraplegia). Individuals aged 60 years at the time of injury have a life expectancy of approximately 7 years (patients with tetraplegia), 9 years (patients with low tetraplegia), and 13 years (patients with paraplegia). The annual death rate for patients with acute SCI is 750-1000 deaths per year in the United States.

Leading cause of death 

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pneumonia and other respiratory conditions, followed by heart disease, subsequent trauma, and septicemia. Suicide and alcohol-related deaths are also major causes of death in patients with SCI. In persons with SCI, the Among patients with incomplete paraplegia, the leading causes of death are cancer and suicide (1:1 ratio), while among persons with complete suicide rate is higher among individuals who are younger than 25 years. paraplegia, the leading cause of death is suicide, followed by heart disease.